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General NPI Number Information
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NPI Number | 1780078188
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Entity Type | Organization
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Legal Business Name | CENTERED IN SELF COUNSELING AND COACHING SERVICES, LLC
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 6700 S FLORIDA AVE STE 27
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City | LAKELAND
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State | FL
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Zip | 33813-3312
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Country | US
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Telephone | 863-660-7915
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Fax |
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Provider Business Mailing Address
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Address Line | 6700 S FLORIDA AVE STE 27
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City | LAKELAND
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State | FL
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Zip | 33813-3312
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Country | US
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Telephone | 863-660-7915
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MAYELLY ALEXANDRA CASAL
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Credential | LMHC,CAP
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Telephone | 863-660-7915
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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 | 12062
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License Number State | FL
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