Provider Demographics
NPI:1134984321
Name:SELF CARE COUNSELING OF SOUTH FLORIDA, INC.
Entity type:Organization
Organization Name:SELF CARE COUNSELING OF SOUTH FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SOCKOL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-531-2338
Mailing Address - Street 1:13762 W STATE ROAD 84 UNIT 159
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-5305
Mailing Address - Country:US
Mailing Address - Phone:954-667-9844
Mailing Address - Fax:
Practice Address - Street 1:8461 LAKE WORTH RD #205
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:954-667-9844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health