Provider Demographics
NPI:1609165380
Name:A STABLE LIFE COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:A STABLE LIFE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:321-377-2243
Mailing Address - Street 1:114 W 1ST ST
Mailing Address - Street 2:246
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1273
Mailing Address - Country:US
Mailing Address - Phone:321-377-2243
Mailing Address - Fax:407-680-1865
Practice Address - Street 1:114 W 1ST ST
Practice Address - Street 2:246
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1273
Practice Address - Country:US
Practice Address - Phone:321-377-2243
Practice Address - Fax:407-680-1865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7013101YM0800X
FLSW77761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty