Provider Demographics
NPI:1588687826
Name:COUNSELING AND PSYCHOLOGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:COUNSELING AND PSYCHOLOGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC LMPT
Authorized Official - Phone:850-478-2444
Mailing Address - Street 1:6160 N DAVIS HWY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6994
Mailing Address - Country:US
Mailing Address - Phone:850-478-2444
Mailing Address - Fax:850-494-2500
Practice Address - Street 1:6160 N DAVIS HWY
Practice Address - Street 2:SUITE 9
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6994
Practice Address - Country:US
Practice Address - Phone:850-478-2444
Practice Address - Fax:850-494-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLX0804Medicare ID - Type Unspecified