Provider Demographics
NPI:1962827386
Name:GARDENS COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:GARDENS COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV,MA
Authorized Official - Phone:561-624-4785
Mailing Address - Street 1:600 SANDTREE DR STE 205
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1538
Mailing Address - Country:US
Mailing Address - Phone:561-624-4785
Mailing Address - Fax:
Practice Address - Street 1:600 SANDTREE DR STE 205
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1538
Practice Address - Country:US
Practice Address - Phone:561-624-4785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0001966251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10748294OtherCAHQ