| Black Swan Counseling Services, Llc | |
|
122 E Main St Lakeland FL 33801-4655 | |
| (863) 667-8570 | |
| Not Available |
| Full Name | Black Swan Counseling Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 122 E Main St, Lakeland, Florida |
| Authorized Official Name and Position | Kevin Berry (MANAGING PARTNER) |
| Authorized Official Contact | 8636678570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Swan Counseling Services, Llc 1908 Griffins Green Blvd Bartow FL 33830-7930 Ph: () - | Black Swan Counseling Services, Llc 122 E Main St Lakeland FL 33801-4655 Ph: (863) 667-8570 |
| NPI Number | 1841070109 |
|---|---|
| Provider Enumeration Date | 10/04/2023 |
| Last Update Date | 10/04/2023 |
| Certification Date | 10/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841070109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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