Provider Demographics
NPI:1679926638
Name:EPIC COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:EPIC COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-278-3754
Mailing Address - Street 1:1350 COUNTY ROAD 1 UNIT 196
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-4601
Mailing Address - Country:US
Mailing Address - Phone:727-278-3754
Mailing Address - Fax:
Practice Address - Street 1:1350 COUNTY ROAD 1 UNIT 196
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-4601
Practice Address - Country:US
Practice Address - Phone:727-278-3754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW117401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty