Provider Demographics
NPI:1487265260
Name:HAPPYVILLE COUNSELING LLC
Entity type:Organization
Organization Name:HAPPYVILLE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-698-2610
Mailing Address - Street 1:827 TOLUCA ST SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-7420
Mailing Address - Country:US
Mailing Address - Phone:321-272-1371
Mailing Address - Fax:321-241-2955
Practice Address - Street 1:827 TOLUCA ST SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-7420
Practice Address - Country:US
Practice Address - Phone:321-272-1371
Practice Address - Fax:321-241-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health