Provider Demographics
NPI:1578380960
Name:MCL COUNSELING & CONSULTING LLC
Entity type:Organization
Organization Name:MCL COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAMAZARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-962-0366
Mailing Address - Street 1:1276 NETTLES BLVD
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-3397
Mailing Address - Country:US
Mailing Address - Phone:305-962-0366
Mailing Address - Fax:
Practice Address - Street 1:1276 NETTLES BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-3397
Practice Address - Country:US
Practice Address - Phone:305-962-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty