Provider Demographics
NPI:1538407291
Name:RESOLVE COMMUNITY COUNSELING OF COLLIER COUNTY LLC
Entity type:Organization
Organization Name:RESOLVE COMMUNITY COUNSELING OF COLLIER COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-331-4774
Mailing Address - Street 1:3050 HORSESHOE DR N
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-7911
Mailing Address - Country:US
Mailing Address - Phone:239-331-4774
Mailing Address - Fax:239-331-4674
Practice Address - Street 1:3050 HORSESHOE DR N
Practice Address - Street 2:SUITE 150
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-7911
Practice Address - Country:US
Practice Address - Phone:239-331-4774
Practice Address - Fax:239-331-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2011AD0820-01261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)