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General NPI Number Information
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NPI Number | 1578426961
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Entity Type | Organization
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Legal Business Name | MKS COUNSELING LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1414 NW 107TH AVE STE 109
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City | SWEETWATER
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State | FL
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Zip | 33172-2739
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Country | US
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Telephone | 786-762-2952
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Fax |
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Provider Business Mailing Address
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Address Line | 20191 E COUNTRY CLUB DR APT 2707
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City | AVENTURA
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State | FL
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Zip | 33180-3023
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AMBR
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Name | MICHELLE KOPCHINSKY SIEGAL
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Credential |
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Telephone | 305-469-0704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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