Provider Demographics
NPI:1518639160
Name:DESTIN COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:DESTIN COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:STILLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, ATR-BC
Authorized Official - Phone:850-710-0295
Mailing Address - Street 1:120 BENNING DR STE 1
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2432
Mailing Address - Country:US
Mailing Address - Phone:850-687-4333
Mailing Address - Fax:833-208-6587
Practice Address - Street 1:120 BENNING DR STE 1
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2432
Practice Address - Country:US
Practice Address - Phone:850-710-0295
Practice Address - Fax:833-208-6587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health