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General NPI Number Information
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NPI Number | 1558895755
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Entity Type | Organization
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Legal Business Name | DDP FAMILY & INDIVIDUAL COUNSELING, LLC
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 7501 WILES RD SUITE 102B
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2063
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Country | US
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Telephone | 954-540-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 4455 BANYAN TRAILS DR
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City | COCONUT CREEK
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State | FL
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Zip | 33073-5109
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Country | US
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Telephone | 954-540-4583
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | DAVID J SCHLAGTER
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Credential | LCSW
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Telephone | 954-540-4583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW6736
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License Number State | FL
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