Provider Demographics
NPI:1710938410
Name:COUNSELING AND EMPLOYEE ASSISTANCE PROGRAM INC
Entity Type:Organization
Organization Name:COUNSELING AND EMPLOYEE ASSISTANCE PROGRAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-435-1606
Mailing Address - Street 1:2375 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4440
Mailing Address - Country:US
Mailing Address - Phone:239-435-1606
Mailing Address - Fax:239-435-1607
Practice Address - Street 1:2375 TAMIAMI TRL N
Practice Address - Street 2:SUITE 306
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4440
Practice Address - Country:US
Practice Address - Phone:239-435-1606
Practice Address - Fax:239-435-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0451Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER