Provider Demographics
NPI:1407303944
Name:REALITY CHECK COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:REALITY CHECK COUNSELING SERVICES, LLC
Other - Org Name:REALITY CHECK CS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-512-6574
Mailing Address - Street 1:321 N DEVILLIERS ST
Mailing Address - Street 2:STE 209
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-3890
Mailing Address - Country:US
Mailing Address - Phone:850-512-6574
Mailing Address - Fax:850-466-3959
Practice Address - Street 1:321 N DEVILLIERS ST
Practice Address - Street 2:STE 209
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3890
Practice Address - Country:US
Practice Address - Phone:850-512-6574
Practice Address - Fax:850-466-3959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017772600Medicaid