Provider Demographics
NPI:1487901914
Name:EIRENE COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:EIRENE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:407-992-4452
Mailing Address - Street 1:1802 N ALAFAYA TRL
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4716
Mailing Address - Country:US
Mailing Address - Phone:407-992-4452
Mailing Address - Fax:407-482-7578
Practice Address - Street 1:1802 N ALAFAYA TRL
Practice Address - Street 2:SUITE 119
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4716
Practice Address - Country:US
Practice Address - Phone:407-992-4452
Practice Address - Fax:407-482-7578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty