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General NPI Number Information
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NPI Number | 1831485259
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Entity Type | Organization
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Legal Business Name | COUNSELING AND BEHAVIORAL SOLUTIONS, INC.
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 102 W. DIXIE AVE
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City | LEESBURG
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State | FL
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Zip | 34748
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Country | US
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Telephone | 352-323-8872
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Fax | 352-801-7376
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Provider Business Mailing Address
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Address Line | P.O. BOX 491459
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City | LEESBURG
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State | FL
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Zip | 34749
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Country | US
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Telephone | 352-323-8872
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Fax | 352-801-7376
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | MRS. KIRSTEN SKOVMAND-WILSON
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Credential | LMHC
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Telephone | 352-323-8872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-01-0570
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 6627
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License Number State | FL
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