Provider Demographics
NPI:1144730003
Name:SEEKING THERAPY AND REACHING FOR SUCCESS COUNSELING SERVCES
Entity type:Organization
Organization Name:SEEKING THERAPY AND REACHING FOR SUCCESS COUNSELING SERVCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLENE
Authorized Official - Middle Name:V
Authorized Official - Last Name:BERKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW INTERN
Authorized Official - Phone:863-500-2480
Mailing Address - Street 1:PO BOX 6482
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33807-6482
Mailing Address - Country:US
Mailing Address - Phone:863-500-2480
Mailing Address - Fax:
Practice Address - Street 1:5475 WILMINGTON CIR APT 209
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2764
Practice Address - Country:US
Practice Address - Phone:863-500-2480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW12071251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health