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General NPI Number Information
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NPI Number | 1942017694
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Entity Type | Organization
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Legal Business Name | PREMIER COUNSELING OF FLORIDA LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 904-671-7223
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Fax |
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Provider Business Mailing Address
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Address Line | 67 OAKHURST CT
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-5423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABRIELLA CARSON
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Credential | LMFT, PH.D.
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Telephone | 904-651-2357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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