Provider Demographics
NPI:1174505234
Name:COUNSELING & PSYCHOTHERAPY CENTERS OF FL INC
Entity Type:Organization
Organization Name:COUNSELING & PSYCHOTHERAPY CENTERS OF FL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LMFT
Authorized Official - Phone:813-948-6000
Mailing Address - Street 1:PO BOX 2548
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548
Mailing Address - Country:US
Mailing Address - Phone:813-948-6000
Mailing Address - Fax:813-929-9891
Practice Address - Street 1:153 US HWAY 41 N
Practice Address - Street 2:SUITE H
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549
Practice Address - Country:US
Practice Address - Phone:813-948-6000
Practice Address - Fax:813-929-9891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT81106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z1043OtherBCBS