Provider Demographics
NPI:1588364699
Name:BOCA GRANDE COUNSELING LLC
Entity type:Organization
Organization Name:BOCA GRANDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABADIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:941-786-4947
Mailing Address - Street 1:975 N BOUNDARY RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2312
Mailing Address - Country:US
Mailing Address - Phone:941-786-4947
Mailing Address - Fax:310-923-7704
Practice Address - Street 1:975 N BOUNDARY RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-2312
Practice Address - Country:US
Practice Address - Phone:941-786-4947
Practice Address - Fax:310-923-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty