Provider Demographics
NPI:1386124816
Name:INFINITE POSSIBILITIES COUNSELING SERVICES
Entity type:Organization
Organization Name:INFINITE POSSIBILITIES COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-270-3343
Mailing Address - Street 1:3415 KEARSNEY ABBEY CIR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:FL
Mailing Address - Zip Code:33527-6381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:806 W DE LEON ST STE 203
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2713
Practice Address - Country:US
Practice Address - Phone:813-270-3343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW129381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty