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General NPI Number Information
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NPI Number | 1710346812
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Entity Type | Organization
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Legal Business Name | PERDIDO COUNSELING PROFESSIONALS, INC.
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 12385 SORRENTO RD STE A3
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City | PENSACOLA
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State | FL
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Zip | 32507-8656
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Country | US
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Telephone | 850-291-8983
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 SEAFARERS WAY
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City | PENSACOLA
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State | FL
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Zip | 32526-2560
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Country | US
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Telephone | 850-291-8983
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | CHRISTINE ABAD
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Credential | LMHC
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Telephone | 850-291-8983
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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 | MH11399
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License Number State | FL
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