Provider Demographics
NPI:1053073304
Name:PREVAIL AND PROGRESS COUNSELING PLLC
Entity Type:Organization
Organization Name:PREVAIL AND PROGRESS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:SIMONE
Authorized Official - Last Name:CRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-300-7080
Mailing Address - Street 1:18704 SW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6906
Mailing Address - Country:US
Mailing Address - Phone:305-812-6018
Mailing Address - Fax:
Practice Address - Street 1:18704 SW 100TH AVE
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6906
Practice Address - Country:US
Practice Address - Phone:305-812-6018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1083961171OtherNPI