Organization
DIVINE INTERVENTIONS & COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL L.T. ROBERSON (PSYCHOTHERAPIST)
(478) 305-3019
Entity
Organization
Contact information
Practice address
31055 PARROT REEF CT, WESLEY CHAPEL, FL 33545-5149
(478) 305-3019
Mailing address
31055 PARROT REEF CT, WESLEY CHAPEL, FL 33545-5149
(478) 305-3019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133171A
—
GA
Enumeration date
02/25/2013
Last updated
02/01/2024
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