Provider Demographics
NPI:1528819836
Name:BEAUSEJOUR & ADAMS COUNSELING SERVICE
Entity type:Organization
Organization Name:BEAUSEJOUR & ADAMS COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HERLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUSEJOUR-BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-403-4417
Mailing Address - Street 1:5044 SABLE CHIME DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-4171
Mailing Address - Country:US
Mailing Address - Phone:813-403-4417
Mailing Address - Fax:
Practice Address - Street 1:5044 SABLE CHIME DR
Practice Address - Street 2:
Practice Address - City:WIMAUMA
Practice Address - State:FL
Practice Address - Zip Code:33598-4171
Practice Address - Country:US
Practice Address - Phone:813-403-4417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health