Provider Demographics
NPI:1497295729
Name:SJD COUNSELING LLC
Entity Type:Organization
Organization Name:SJD COUNSELING LLC
Other - Org Name:A BALANCED PERSPECTIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:954-204-4123
Mailing Address - Street 1:1040 BAYVIEW DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2522
Mailing Address - Country:US
Mailing Address - Phone:954-204-4123
Mailing Address - Fax:
Practice Address - Street 1:1040 BAYVIEW DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-2522
Practice Address - Country:US
Practice Address - Phone:954-204-4123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 3087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty