Deyanira Cotilla

Individual provider Active NPI Mental Health Counselor · Labelle, FL

NPI 1508309816 · NPPES record last updated Nov 18, 2016

Key facts

NPI
1508309816
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
483 E Cowboy Way
Labelle, FL 33935-4402
Phone
(863) 674-5012
NPI assigned
Nov 18, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Behavioral Health Center, Inc. Past
since Mar 3, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

483 E Cowboy Way
Labelle, FL 33935-4402

Mailing address

483 E Cowboy Way
Labelle, FL 33935-4402
Phone (863) 674-5012

Other providers in Labelle, FL

All providers in Labelle, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.