Provider Demographics
NPI:1851812804
Name:WITH OPEN ARMS COUNSELING, LLC
Entity Type:Organization
Organization Name:WITH OPEN ARMS COUNSELING, LLC
Other - Org Name:WITH OPEN ARMS COUNSELING AND CONSULTING
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLICILE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORMEUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-892-4723
Mailing Address - Street 1:2170 NW 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3816
Mailing Address - Country:US
Mailing Address - Phone:954-892-4723
Mailing Address - Fax:
Practice Address - Street 1:3810 INVERRARY BLVD STE 404A
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4381
Practice Address - Country:US
Practice Address - Phone:954-892-4723
Practice Address - Fax:954-546-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW113101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty