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General NPI Number Information
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NPI Number | 1689080780
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Entity Type | Organization
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Legal Business Name | PINECREST COUNSELING
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 12368 SW 82 AVE
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City | PINECREST
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State | FL
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Zip | 33156
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Country | US
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Telephone | 305-667-5595
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Fax | 305-259-6015
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Provider Business Mailing Address
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Address Line | 10351 SW 119 ST
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City | MIAMI
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State | FL
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Zip | 33176
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Country | US
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Telephone | 305-667-5595
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Fax | 305-259-6015
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Authorized Official
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Title or Position | PRESIDENT.
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Name | IRIS MORE
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Credential | L.C.S.W.
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Telephone | 305-667-5595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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