Provider Demographics
NPI:1619381324
Name:KBS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:KBS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:BLAINE
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:ISW 7420, CAP 4647
Authorized Official - Phone:305-310-6618
Mailing Address - Street 1:4810 W BEXLEY PARK DR
Mailing Address - Street 2:UNIT C
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3577
Mailing Address - Country:US
Mailing Address - Phone:305-310-6618
Mailing Address - Fax:
Practice Address - Street 1:4810 W BEXLEY PARK DR
Practice Address - Street 2:UNIT C
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3577
Practice Address - Country:US
Practice Address - Phone:305-310-6618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty