Provider Demographics
NPI:1306933379
Name:MV COUNSELING SERVICES INC
Entity type:Organization
Organization Name:MV COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINERVA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-436-7158
Mailing Address - Street 1:141 EXECUTIVE CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1835
Mailing Address - Country:US
Mailing Address - Phone:561-436-7158
Mailing Address - Fax:561-736-0354
Practice Address - Street 1:5700 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4727
Practice Address - Country:US
Practice Address - Phone:561-436-7158
Practice Address - Fax:561-736-0354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW55491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0458Medicare PIN