Provider Demographics
NPI:1730726811
Name:AFFINITY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:AFFINITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:YOHAIRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FAJARDO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-856-5620
Mailing Address - Street 1:2101 VISTA PKWY
Mailing Address - Street 2:SUITE 235
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-856-5620
Mailing Address - Fax:
Practice Address - Street 1:13133 ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8422
Practice Address - Country:US
Practice Address - Phone:561-856-5620
Practice Address - Fax:561-623-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-07
Last Update Date:2019-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty