| Complete Counseling Group, Inc. | |
|
3115 Nw 10th Ter Ste 103 Oakland Park FL 33309-5937 | |
| (954) 236-6676 | |
| (954) 772-1023 |
| Full Name | Complete Counseling Group, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 3115 Nw 10th Ter Ste 103, Oakland Park, Florida |
| Authorized Official Name and Position | Debra J Tantillo (PRESIDENT EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9547325418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Counseling Group, Inc. 333 Nw 46th St Fort Lauderdale FL 33309-4010 Ph: (954) 732-5418 | Complete Counseling Group, Inc. 3115 Nw 10th Ter Ste 103 Oakland Park FL 33309-5937 Ph: (954) 236-6676 |
| NPI Number | 1710009873 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 09/12/2022 |
| Certification Date | 09/12/2022 |
| Medicare PECOS PAC ID | 9537337027 |
|---|---|
| Medicare Enrollment ID | O20110728000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710009873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | SW5538 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Debra J Tantillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376822981 PECOS PAC ID: 5294903795 Enrollment ID: I20110902000027 |
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