Provider Demographics
NPI:1437292943
Name:NURTURING COUNSELING CENTER
Entity Type:Organization
Organization Name:NURTURING COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:MCKIM
Authorized Official - Suffix:
Authorized Official - Credentials:LHMC
Authorized Official - Phone:850-434-6774
Mailing Address - Street 1:1720 W FAIRFIELD DR
Mailing Address - Street 2:PLAZA BLDG, SUITE 301
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1052
Mailing Address - Country:US
Mailing Address - Phone:850-434-6774
Mailing Address - Fax:850-434-6784
Practice Address - Street 1:1720 W FAIRFIELD DR
Practice Address - Street 2:PLAZA BLDG, SUITE 301
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1052
Practice Address - Country:US
Practice Address - Phone:850-434-6774
Practice Address - Fax:850-434-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266591Medicaid