MEDICARE: EBENEZER COUNSELING SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1700765880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EBENEZER COUNSELING SERVICES INC

Provider Business Mailing Address
First Line	:	11249 SW 34TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3411
Country	:	US
Telephone Number	:	305-877-9150
Fax Number	:

Provider Business Practice Location Address
First Line	:	11249 SW 34TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3411
Country	:	US
Telephone Number	:	305-877-9150
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KARELYS VELIZ PEREZ
Credential	:
Telephone Number	:	305-877-9150

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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