Provider Demographics
NPI:1730991316
Name:WONDERLEY CONSULTATION AND COUNSELING SERVICES
Entity type:Organization
Organization Name:WONDERLEY CONSULTATION AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARNI
Authorized Official - Middle Name:I
Authorized Official - Last Name:WONDERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-530-6429
Mailing Address - Street 1:2972 ALLEGRA WAY
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6998
Mailing Address - Country:US
Mailing Address - Phone:813-530-6429
Mailing Address - Fax:
Practice Address - Street 1:2972 ALLEGRA WAY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6998
Practice Address - Country:US
Practice Address - Phone:813-530-6429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty