Provider Demographics
NPI:1881005254
Name:PERSONALIZED COUNSELING SERVICES OF OCALA,INC.
Entity Type:Organization
Organization Name:PERSONALIZED COUNSELING SERVICES OF OCALA,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:352-362-6094
Mailing Address - Street 1:PO BOX 932
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-0932
Mailing Address - Country:US
Mailing Address - Phone:352-362-6094
Mailing Address - Fax:352-237-6801
Practice Address - Street 1:2227 S. PINE AVE.
Practice Address - Street 2:SUITE 102
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5132
Practice Address - Country:US
Practice Address - Phone:352-362-6094
Practice Address - Fax:352-237-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW35091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty