Provider Demographics
NPI:1639659246
Name:QUANTUM RECOVERY COUNSELING LLC
Entity Type:Organization
Organization Name:QUANTUM RECOVERY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:CEFALU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-528-1165
Mailing Address - Street 1:635 EUCLID AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-8666
Mailing Address - Country:US
Mailing Address - Phone:305-528-1165
Mailing Address - Fax:305-705-3236
Practice Address - Street 1:635 EUCLID AVE APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-8666
Practice Address - Country:US
Practice Address - Phone:305-528-1165
Practice Address - Fax:305-705-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW153261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW15326OtherMENTAL HEALTH COUNSELING