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Organization
HIBISCUS COUNSELING CENTER PLLC
Active
Organization
HIBISCUS COUNSELING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGALYS KOCH LCSW (OWNER/ PRACTIONER)
(772) 249-8255
Entity
Organization
Contact information
Practice address
549 SE STARFLOWER AVE, PORT SAINT LUCIE, FL 34983-4578
(772) 249-8255
(772) 249-8256
Mailing address
1981 SE PORT ST LUCIE BLVD, SUITE 2, PORT SAINT LUCIE, FL 34952-5555
(772) 249-8255
(772) 249-8256
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW9799
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI480Z
PTAN
FL
Enumeration date
02/06/2013
Last updated
03/27/2013
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