Provider Demographics
NPI:1710276431
Name:ALLISON VINSON COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:ALLISON VINSON COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-305-1832
Mailing Address - Street 1:151 MARY ESTHER BLVD
Mailing Address - Street 2:SUITE 308A
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1972
Mailing Address - Country:US
Mailing Address - Phone:850-305-1832
Mailing Address - Fax:850-226-4981
Practice Address - Street 1:151 MARY ESTHER BLVD
Practice Address - Street 2:SUITE 308A
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1972
Practice Address - Country:US
Practice Address - Phone:850-305-1832
Practice Address - Fax:850-226-4981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-9857273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit