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General NPI Number Information
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NPI Number | 1710276431
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Entity Type | Organization
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Legal Business Name | ALLISON VINSON COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 151 MARY ESTHER BLVD SUITE 308A
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City | MARY ESTHER
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State | FL
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Zip | 32569-1972
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Country | US
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Telephone | 850-305-1832
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Fax | 850-226-4981
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Provider Business Mailing Address
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Address Line | 151 MARY ESTHER BLVD SUITE 308A
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City | MARY ESTHER
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State | FL
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Zip | 32569-1972
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Country | US
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Telephone | 850-305-1832
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Fax | 850-226-4981
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Authorized Official
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Title or Position | LCSW
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Name | MRS. ALLISON VINSON
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Credential | LCSW
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Telephone | 850-305-1832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | SW-9857
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License Number State | FL
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