| His Therapeutic Counseling Center Llc | |
|
6415 Lake Worth Rd Suite 208 Greenacres FL 33463-2910 | |
| (561) 252-3787 | |
| Not Available |
| Full Name | His Therapeutic Counseling Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6415 Lake Worth Rd, Greenacres, Florida |
| Authorized Official Name and Position | Elcie Ardain (SOCIAL WORKER) |
| Authorized Official Contact | 5612523787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| His Therapeutic Counseling Center Llc 8387 Myakka Ct Lake Worth FL 33467-6228 Ph: (561) 252-3787 | His Therapeutic Counseling Center Llc 6415 Lake Worth Rd Suite 208 Greenacres FL 33463-2910 Ph: (561) 252-3787 |
| NPI Number | 1053734616 |
|---|---|
| Provider Enumeration Date | 01/31/2014 |
| Last Update Date | 03/12/2014 |
| Medicare PECOS PAC ID | 7517199888 |
|---|---|
| Medicare Enrollment ID | O20140421001193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053734616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW8983 (Florida) | Primary |
| Provider Name | Elcie Ardain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104083773 PECOS PAC ID: 9234361502 Enrollment ID: I20140421001242 |
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