Provider Demographics
NPI:1063838951
Name:STEPHANIE COBERLY, LMHC PA
Entity Type:Organization
Organization Name:STEPHANIE COBERLY, LMHC PA
Other - Org Name:SOUTH FLORIDA THERAPEUTIC SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-324-8383
Mailing Address - Street 1:9050 PINES BLVD STE 383
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6400
Mailing Address - Country:US
Mailing Address - Phone:954-324-8383
Mailing Address - Fax:954-324-8383
Practice Address - Street 1:9050 PINES BLVD STE 383
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6400
Practice Address - Country:US
Practice Address - Phone:954-324-8383
Practice Address - Fax:954-324-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-15
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9399101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty