| Advanced Counseling Care And Change Inc | |
|
5545 Berryman St Lehigh Acres FL 33971-6470 | |
| (239) 200-2141 | |
| Not Available |
| Full Name | Advanced Counseling Care And Change Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5545 Berryman St, Lehigh Acres, Florida |
| Authorized Official Name and Position | Susana Colaluci (OWNER) |
| Authorized Official Contact | 2392002141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Counseling Care And Change Inc 5545 Berryman St Lehigh Acres FL 33971-6470 Ph: (239) 200-2141 | Advanced Counseling Care And Change Inc 5545 Berryman St Lehigh Acres FL 33971-6470 Ph: (239) 200-2141 |
| NPI Number | 1588155568 |
|---|---|
| Provider Enumeration Date | 05/24/2018 |
| Last Update Date | 11/03/2021 |
| Certification Date | 11/03/2021 |
| Medicare PECOS PAC ID | 5890049365 |
|---|---|
| Medicare Enrollment ID | O20181120000686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588155568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Susana Colaluci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801285390 PECOS PAC ID: 0547512717 Enrollment ID: I20181017000003 |
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