MANDALA COUNSELING SERVICES LLC (NPI# 1871134627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871134627 |
| Entity Type | Organization |
| Organization Name | MANDALA COUNSELING SERVICES LLC |
| Practice Address |
6361 Presidential Ct Ste 101 Fort Myers FL 33919-3583 |
| Mailing Address |
101 Se 43rd St Cape Coral FL 33904-8358 |
| Practice Telephone | 2393601976 |
| Mailing Telephone | 2393601976 |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |
| Authorized Official Name | BRIANNA KELLY CHELUCCI (OWNER) |
| Authorized Official Telephone | 9419629661 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376199356 | Mandala Counseling Services LLC | Clinic/Center | 8600 Northwest Hwy # 14, Crystal Lake, IL 60012-2706 | 2019-08-14 |
| Street Address |
6361 PRESIDENTIAL CT STE 101 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33919-3583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629556840 | The Onyx Counseling Center, LLC | Social Worker | 6361 Presidential Ct Ste 101, Fort Myers, FL 33919 | 2018-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073145942 | Patricia June Briand | Registered Nurse | 4309 Mariner Way #307, Fort Myers, FL 33919 | 2020-02-10 |
| 1366980187 | My Precious Kids Therapy Center Inc | Community/Behavioral Health | 4755 Summerlin Road, Suite #4, Fort Myers, FL 33919 | 2017-02-01 |
| 1811342397 | Kimberly Regenesis | Substance Abuse Rehabilitation Facility | 8695 College Parkway, Suite 2080, Ft Myers, FL 33919 | 2016-05-03 |
| 1689030207 | Balance for All, Inc. | Acupuncturist | 6238 Presidential Ct., Ste 6, Fort Myers, FL 33919 | 2016-01-12 |
| 1902275217 | Kelly Jean Overton | Physical Therapist | 6341 Whiskey Creek Drive, Fort Myers, FL 33919 | 2015-09-16 |
| 1508125311 | Charles Clark Dugan IIi | Chiropractor | 6309 Corporate Court, Suite 110, Fort Myers, FL 33919 | 2012-05-14 |
| 1659641231 | Dasha Bich Le | Pharmacist | 9629 Bay Harbor Cir., Apt. 201, Fort Myers, FL 33919 | 2012-01-12 |
| 1164792602 | Gail Lee Rathbun | Nurse Practitioner | 6311 S. Pointe Blvd., Fort Meyers, FL 33919 | 2011-12-30 |
| 1871878173 | Scott Kozlowski | Behavioral Analyst | 5335 Shalley Cir., Ft. Myers, FL 33919 | 2011-10-18 |
| 1396074464 | Phyllis Ann Wolford | Nurse Practitioner | 6311 S. Pointe Blvd, Fort Myers, FL 33919 | 2009-12-18 |
| Find all providers in zip 33919 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413305 | Shantell Pepe | Counselor | 4310 Metro Pkwy Ste 200, Fort Myers, FL 33916-9462 | 2020-09-29 |
| 1548879091 | Linda Ann Weaver | Counselor | 12811 Kenwood Ln Ste 202-213, Fort Myers, FL 33907-5667 | 2020-07-29 |
| 1710502166 | Cornerstone Consultants | Counselor | 1344 Bradford Rd, Fort Myers, FL 33901-8804 | 2020-06-11 |
| 1053935981 | Timothy D Solomon | Counselor | 12557 New Brittany Blvd Ste 31-2, Fort Myers, FL 33907-3651 | 2020-06-06 |
| 1487275418 | Hofmann Counseling and Consulting, LLC. | Counselor | 8925 Beacon Street, Fort Myers, FL 33907-3390 | 2020-04-30 |
| 1760002927 | Angela Maria Molina | Counselor | 11932 Fairway Lakes Dr, Fort Myers, FL 33913-8337 | 2020-04-17 |
| 1386272334 | Chrysallis Wellness Center Inc | Counselor | 11932 Faiway Lakes, Fort Myers, FL 33913 | 2020-03-27 |
| 1710512454 | Kelleen Marguerite Linden | Counselor | 12670 New Brittany Blvd Ste 204, Fort Myers, FL 33907-3650 | 2020-03-03 |
| 1194369355 | Mary Alice Robinson | Counselor | 4531 Deleon St Ste 206, Fort Myers, FL 33907-1280 | 2019-10-31 |
| 1942855580 | Susan Lee Bobrow | Counselor | 3049 Cleveland Ave Ste 295, Fort Myers, FL 33901-7054 | 2019-08-08 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33919 |
Please comment or provide details below to improve the information on MANDALA COUNSELING SERVICES LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.