Provider Demographics
NPI:1497062491
Name:COUNSELING FOR YOUR SUCCESS LLC
Entity Type:Organization
Organization Name:COUNSELING FOR YOUR SUCCESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOENSSENS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC, LMFT
Authorized Official - Phone:321-230-0740
Mailing Address - Street 1:244 E HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2508
Mailing Address - Country:US
Mailing Address - Phone:321-230-0740
Mailing Address - Fax:
Practice Address - Street 1:244 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2508
Practice Address - Country:US
Practice Address - Phone:321-230-0740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-12
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9675101YM0800X
FLMT2360106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty