Provider Demographics
NPI:1699379230
Name:CROWN OF GLORY COUNSELING CORP.
Entity Type:Organization
Organization Name:CROWN OF GLORY COUNSELING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:RMHC
Authorized Official - Phone:561-320-3640
Mailing Address - Street 1:11440 OKEECHOBEE BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8726
Mailing Address - Country:US
Mailing Address - Phone:561-320-3640
Mailing Address - Fax:
Practice Address - Street 1:11440 OKEECHOBEE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8726
Practice Address - Country:US
Practice Address - Phone:561-320-3640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty