Provider Demographics
NPI:1912130576
Name:DEBRA T. SEGAL COUNSELING, P.A.
Entity Type:Organization
Organization Name:DEBRA T. SEGAL COUNSELING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-299-2202
Mailing Address - Street 1:65 3RD ST NW
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4670
Mailing Address - Country:US
Mailing Address - Phone:863-299-2202
Mailing Address - Fax:863-299-9661
Practice Address - Street 1:65 3RD ST NW
Practice Address - Street 2:SUITE 210
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4670
Practice Address - Country:US
Practice Address - Phone:863-299-2202
Practice Address - Fax:863-299-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty