Provider Demographics
NPI:1891865762
Name:COUNSELING AND BEHAVIORAL SERVICES, INC
Entity Type:Organization
Organization Name:COUNSELING AND BEHAVIORAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSLOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JEFFERY
Authorized Official - Last Name:DUGGAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-596-1208
Mailing Address - Street 1:619 COVE BLVD SUITE A
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401
Mailing Address - Country:US
Mailing Address - Phone:850-596-1208
Mailing Address - Fax:850-769-2366
Practice Address - Street 1:619 N COVE BLVD STE A
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3642
Practice Address - Country:US
Practice Address - Phone:850-596-1208
Practice Address - Fax:850-769-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ012UOtherBCBS OF FL
FLZ012UOtherBCBS OF FL
FL=========OtherCOMMERCIAL INSURANCE
FL=========OtherTRICARE