Provider Demographics
NPI:1518036102
Name:THE COUNSELING CENTER OF KEY WEST INC
Entity Type:Organization
Organization Name:THE COUNSELING CENTER OF KEY WEST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EMILE
Authorized Official - Last Name:ERSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-294-8777
Mailing Address - Street 1:1111 12TH STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040
Mailing Address - Country:US
Mailing Address - Phone:305-294-8777
Mailing Address - Fax:305-294-8298
Practice Address - Street 1:1111 12TH STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040
Practice Address - Country:US
Practice Address - Phone:305-294-8777
Practice Address - Fax:305-294-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME178882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96157OtherBCBS
FLZ002MOtherBCBS
FL96157OtherBCBS
FLZ002MOtherBCBS
FL260026186Medicare ID - Type UnspecifiedRR
FLK3041Medicare PIN