Provider Demographics
NPI:1932897766
Name:THE POP-IN COUNSELOR
Entity Type:Organization
Organization Name:THE POP-IN COUNSELOR
Other - Org Name:THE POP-IN COUNSELOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC
Authorized Official - Phone:850-238-7131
Mailing Address - Street 1:550 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-3506
Mailing Address - Country:US
Mailing Address - Phone:850-238-7131
Mailing Address - Fax:
Practice Address - Street 1:550 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-3506
Practice Address - Country:US
Practice Address - Phone:850-238-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGIANCE RESILIENCY THERAPY L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-28
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health