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General NPI Number Information
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NPI Number | 1821837394
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Entity Type | Organization
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Legal Business Name | MOBILE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 728 FENTRESS BLVD UNIT E
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1214
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Country | US
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Telephone | 321-239-4124
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Fax | 386-204-7363
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Provider Business Mailing Address
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Address Line | 728 FENTRESS BLVD UNIT E
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1214
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Country | US
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Telephone | 321-239-4124
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Fax | 386-204-7363
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Authorized Official
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Title or Position | LCSW
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Name | CAROLINE MARKS
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Credential | OWNER
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Telephone | 813-335-8622
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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 |
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License Number State |
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