Provider Demographics
NPI:1164085197
Name:OCEAN BREEZE COUNSELING, LLC
Entity Type:Organization
Organization Name:OCEAN BREEZE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-626-7122
Mailing Address - Street 1:202 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-3114
Mailing Address - Country:US
Mailing Address - Phone:321-626-7122
Mailing Address - Fax:
Practice Address - Street 1:202 4TH AVE
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-3114
Practice Address - Country:US
Practice Address - Phone:321-626-7122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty