Provider Demographics
NPI:1962097329
Name:BRADENTON BEST LIFE COUNSELING CENTER LLC
Entity type:Organization
Organization Name:BRADENTON BEST LIFE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARMON
Authorized Official - Middle Name:D
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:941-929-3232
Mailing Address - Street 1:9040 TOWN CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-4101
Mailing Address - Country:US
Mailing Address - Phone:941-867-0802
Mailing Address - Fax:
Practice Address - Street 1:9040 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4101
Practice Address - Country:US
Practice Address - Phone:941-867-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-07
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty