Provider Demographics
NPI:1699922435
Name:ARIEL BREEN PROFESSIONAL COUNSELING SERVICES, PA
Entity type:Organization
Organization Name:ARIEL BREEN PROFESSIONAL COUNSELING SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CAP
Authorized Official - Phone:727-815-8100
Mailing Address - Street 1:12110 BEAGLE RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6013
Mailing Address - Country:US
Mailing Address - Phone:727-815-8100
Mailing Address - Fax:
Practice Address - Street 1:5623 US HIGHWAY 19
Practice Address - Street 2:SUITE 104
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3700
Practice Address - Country:US
Practice Address - Phone:727-815-8100
Practice Address - Fax:727-848-6347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8897101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty