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General NPI Number Information
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NPI Number | 1932636115
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Entity Type | Organization
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Legal Business Name | OPUS COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 05/18/2017
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Provider Practice Location Address
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Address Line | 1990 N FEDERAL HWY STE A
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1032
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Country | US
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Telephone | 561-306-0146
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Fax |
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Provider Business Mailing Address
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Address Line | 4181 NW 66TH PL
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2019
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Country | US
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Telephone | 561-306-0146
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KRISTY QUAKA
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Credential | LMHC
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Telephone | 561-306-0146
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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 | MH14576
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License Number State | FL
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