Provider Demographics
NPI:1013461318
Name:MASTERS COUNSELING SERVICES
Entity Type:Organization
Organization Name:MASTERS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MCCOY
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:941-456-9151
Mailing Address - Street 1:PO BOX 494708
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-4708
Mailing Address - Country:US
Mailing Address - Phone:941-456-9151
Mailing Address - Fax:941-456-7181
Practice Address - Street 1:4055 TAMIAMI TRL
Practice Address - Street 2:SUITE 20
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9212
Practice Address - Country:US
Practice Address - Phone:941-456-9151
Practice Address - Fax:941-456-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW1911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty