Provider Demographics
NPI:1588290126
Name:KNOWN AND LOVED COUNSELING CENTER LLC
Entity type:Organization
Organization Name:KNOWN AND LOVED COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:941-685-3716
Mailing Address - Street 1:1636 BOB O LINK DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1338
Mailing Address - Country:US
Mailing Address - Phone:941-685-3716
Mailing Address - Fax:
Practice Address - Street 1:333 TAMIAMI TRL S STE 284
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2441
Practice Address - Country:US
Practice Address - Phone:941-363-1558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty