Provider Demographics
NPI:1487019360
Name:CENTER FOR COUNSELING & DIAGNOSTICS, INC,.
Entity Type:Organization
Organization Name:CENTER FOR COUNSELING & DIAGNOSTICS, INC,.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:LANDY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:239-263-3312
Mailing Address - Street 1:808 ANCHOR RODE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2739
Mailing Address - Country:US
Mailing Address - Phone:239-263-3312
Mailing Address - Fax:239-263-3752
Practice Address - Street 1:808 ANCHOR RODE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2739
Practice Address - Country:US
Practice Address - Phone:239-263-3312
Practice Address - Fax:239-263-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty