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General NPI Number Information
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NPI Number | 1972991636
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Entity Type | Organization
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Legal Business Name | POSITIVE PROGRESS CLINICAL COUNSELING & COACHING PLLC
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 1222 SE 47TH ST STE 217
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City | CAPE CORAL
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State | FL
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Zip | 33904-9661
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Country | US
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Telephone | 239-829-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 SE 47TH ST STE 217
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City | CAPE CORAL
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State | FL
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Zip | 33904-9661
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Country | US
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Telephone | 239-829-5480
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICK MERILLAT
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Credential |
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Telephone | 239-829-5480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW7100
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License Number State | FL
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