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General NPI Number Information
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NPI Number | 1750838264
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Entity Type | Organization
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Legal Business Name | GULF COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 7552 NAVARRE PKWY UNIT 7
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City | NAVARRE
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State | FL
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Zip | 32566-7312
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Country | US
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Telephone | 850-733-6671
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Fax | 855-490-2281
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Provider Business Mailing Address
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Address Line | 6472 BAY OAKS DR
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City | MILTON
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State | FL
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Zip | 32583-7415
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Country | US
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Telephone | 850-733-6671
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KELLY OBRIEN
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Credential | LCSW, MCAP
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Telephone | 850-733-6671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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