Provider Demographics
NPI:1265200448
Name:SMG & ASSOCIATES COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:SMG & ASSOCIATES COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:GERARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:941-356-3656
Mailing Address - Street 1:350 N CATTLEMEN RD APT 306
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6464
Mailing Address - Country:US
Mailing Address - Phone:941-356-3656
Mailing Address - Fax:
Practice Address - Street 1:350 N CATTLEMEN RD APT 306
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6464
Practice Address - Country:US
Practice Address - Phone:941-356-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty