Provider Demographics
NPI:1659638336
Name:COUNSELING FOR EFFECTIVE LIVING INC
Entity Type:Organization
Organization Name:COUNSELING FOR EFFECTIVE LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHALA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENZOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-522-8577
Mailing Address - Street 1:102 SPRINGHILL CIR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3546
Mailing Address - Country:US
Mailing Address - Phone:850-522-8577
Mailing Address - Fax:850-769-2366
Practice Address - Street 1:102 SPRINGHILL CIR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3546
Practice Address - Country:US
Practice Address - Phone:850-522-8577
Practice Address - Fax:850-769-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW76541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9785Medicare PIN