Provider Demographics
NPI:1699105288
Name:COUNSELING & CONSULTATION, CORP.
Entity type:Organization
Organization Name:COUNSELING & CONSULTATION, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAP, CMHP
Authorized Official - Phone:386-290-2085
Mailing Address - Street 1:3959 S. NOVA RD.
Mailing Address - Street 2:SUITE 14
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127
Mailing Address - Country:US
Mailing Address - Phone:386-290-2085
Mailing Address - Fax:
Practice Address - Street 1:3959 S. NOVA RD.
Practice Address - Street 2:SUITE 14
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127
Practice Address - Country:US
Practice Address - Phone:386-290-2085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0764AD394901252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency