Provider Demographics
NPI:1184046807
Name:SUNCOAST COUNSELING LLC
Entity type:Organization
Organization Name:SUNCOAST COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARINI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-277-4628
Mailing Address - Street 1:1621 GULF BLVD
Mailing Address - Street 2:APT 606
Mailing Address - City:CLEARWATER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2974
Mailing Address - Country:US
Mailing Address - Phone:813-277-4628
Mailing Address - Fax:
Practice Address - Street 1:2270 DREW ST
Practice Address - Street 2:SUITE C
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3344
Practice Address - Country:US
Practice Address - Phone:727-784-8244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 11391251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008748300Medicaid
FL008748300Medicaid