Provider Demographics
NPI:1295540110
Name:PROFESSIONAL COUNSELING OF FLORIDA, LLC
Entity type:Organization
Organization Name:PROFESSIONAL COUNSELING OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDEA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PETROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC-S
Authorized Official - Phone:963-359-9539
Mailing Address - Street 1:119 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-6167
Mailing Address - Country:US
Mailing Address - Phone:863-840-3350
Mailing Address - Fax:
Practice Address - Street 1:102 S RIDGEWOOD DR STE 7
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3300
Practice Address - Country:US
Practice Address - Phone:863-359-9539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty