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General NPI Number Information
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NPI Number | 1649926734
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Entity Type | Organization
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Legal Business Name | SRQ COUNSELING, PLLC
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Dates
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Enumeration Date | 02/27/2022
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1188 N TAMIAMI TRL UNIT 205B
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City | SARASOTA
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State | FL
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Zip | 34236-2414
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Country | US
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Telephone | 727-488-3459
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Fax |
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Provider Business Mailing Address
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Address Line | 1258 14TH ST
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City | SARASOTA
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State | FL
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Zip | 34236-2506
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Country | US
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Telephone | 727-488-3459
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | CHELSEA NOBLE
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Credential | LCSW
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Telephone | 727-488-3459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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