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General NPI Number Information
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NPI Number | 1821555665
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Entity Type | Organization
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Legal Business Name | PRACTICE MAKES PURPOSE COUNSELING SERVICES
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 23150 FASHION DR STE UNIT232
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City | ESTERO
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State | FL
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Zip | 33928-8321
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Country | US
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Telephone | 877-365-9355
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Fax | 877-365-9355
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Provider Business Mailing Address
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Address Line | 23150 FASHION DR STE UNIT232
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City | ESTERO
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State | FL
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Zip | 33928-8321
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Country | US
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Telephone | 877-365-9355
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Fax | 877-365-9355
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALEXANDER CONRAD
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Credential | LMHC
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Telephone | 877-365-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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