Provider Demographics
NPI:1114385259
Name:INTEGRATIVE COUNSELING AND CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:INTEGRATIVE COUNSELING AND CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-763-2223
Mailing Address - Street 1:1899 NE 164TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4109
Mailing Address - Country:US
Mailing Address - Phone:786-763-2223
Mailing Address - Fax:
Practice Address - Street 1:1899 NE 164TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162
Practice Address - Country:US
Practice Address - Phone:786-763-2223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2018-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty