Provider Demographics
NPI:1275121121
Name:ESSENTIAL COUNSELING SERVICES
Entity Type:Organization
Organization Name:ESSENTIAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:TOSKES
Authorized Official - Last Name:KONOPKA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:352-318-7983
Mailing Address - Street 1:11647 NW 13TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-0427
Mailing Address - Country:US
Mailing Address - Phone:352-318-7983
Mailing Address - Fax:
Practice Address - Street 1:4421 NW 39TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7221
Practice Address - Country:US
Practice Address - Phone:352-380-0209
Practice Address - Fax:352-380-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH12169OtherMENTAL HEALTH LICENSE
FL1932333127OtherINSURANCE COMPANY