Provider Demographics
NPI:1326219668
Name:PROFESSIONAL COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:PROFESSIONAL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:W
Authorized Official - Last Name:DORROUGH-EWING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:863-471-2226
Mailing Address - Street 1:211 CIRCLE PARK DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-3332
Mailing Address - Country:US
Mailing Address - Phone:863-471-2226
Mailing Address - Fax:863-471-2226
Practice Address - Street 1:211 CIRCLE PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3332
Practice Address - Country:US
Practice Address - Phone:863-471-2226
Practice Address - Fax:863-471-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW70171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty