Provider Demographics
NPI:1609276252
Name:EMERALD COAST COUNSELING & ASSOCIATES
Entity Type:Organization
Organization Name:EMERALD COAST COUNSELING & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-226-7419
Mailing Address - Street 1:151 MARY ESTHER BLVD STE 507
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1976
Mailing Address - Country:US
Mailing Address - Phone:850-226-7419
Mailing Address - Fax:850-362-7403
Practice Address - Street 1:151 MARY ESTHER BLVD STE 507
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1976
Practice Address - Country:US
Practice Address - Phone:850-226-7419
Practice Address - Fax:850-362-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5054101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty