Provider Demographics
NPI:1891745907
Name:COUNSELING ASSOCIATES P A
Entity Type:Organization
Organization Name:COUNSELING ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANGARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED MSW LCSW
Authorized Official - Phone:352-378-0900
Mailing Address - Street 1:2610 NW 43RD ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6675
Mailing Address - Country:US
Mailing Address - Phone:352-378-0900
Mailing Address - Fax:352-378-7849
Practice Address - Street 1:2610 NW 43RD ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6675
Practice Address - Country:US
Practice Address - Phone:352-378-0900
Practice Address - Fax:352-378-7849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW77541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8319Medicare PIN