Provider Demographics
NPI:1134866437
Name:INTERNATIONAL ASSOCIATION OF TRAUMA & ADDICTION COUNSELORS INC.
Entity type:Organization
Organization Name:INTERNATIONAL ASSOCIATION OF TRAUMA & ADDICTION COUNSELORS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-954-1347
Mailing Address - Street 1:4101 S HOSPITAL DR STE 15
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2830
Mailing Address - Country:US
Mailing Address - Phone:954-999-0818
Mailing Address - Fax:954-999-0947
Practice Address - Street 1:4101 S HOSPITAL DR STE 15
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2830
Practice Address - Country:US
Practice Address - Phone:954-999-0818
Practice Address - Fax:954-999-0947
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERNATIONAL ASSOCIATION OF TRAUMA & ADDICTION COUNSELORS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-18
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management