Provider Demographics
NPI:1346607660
Name:COUNSELING COTTAGE LLC
Entity Type:Organization
Organization Name:COUNSELING COTTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:941-350-3009
Mailing Address - Street 1:7313 MERCHANT CT
Mailing Address - Street 2:SUITE L
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8437
Mailing Address - Country:US
Mailing Address - Phone:941-350-3009
Mailing Address - Fax:678-420-6620
Practice Address - Street 1:7313 MERCHANT CT
Practice Address - Street 2:SUITE L
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8437
Practice Address - Country:US
Practice Address - Phone:941-350-3009
Practice Address - Fax:678-420-6620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 13545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty