Provider Demographics
NPI:1720829922
Name:COOL SKIES COUNSELING LLC
Entity type:Organization
Organization Name:COOL SKIES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOLIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMHC
Authorized Official - Phone:253-310-3910
Mailing Address - Street 1:7726 WINEGARD RD FL 2
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7147
Mailing Address - Country:US
Mailing Address - Phone:253-310-3910
Mailing Address - Fax:
Practice Address - Street 1:7726 WINEGARD RD FL 2
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7147
Practice Address - Country:US
Practice Address - Phone:253-310-3910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health