Provider Demographics
NPI:1821837394
Name:MOBILE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:MOBILE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:813-335-8622
Mailing Address - Street 1:728 FENTRESS BLVD UNIT E
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1214
Mailing Address - Country:US
Mailing Address - Phone:321-239-4124
Mailing Address - Fax:386-204-7363
Practice Address - Street 1:728 FENTRESS BLVD UNIT E
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1214
Practice Address - Country:US
Practice Address - Phone:321-239-4124
Practice Address - Fax:386-204-7363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty