Organization
COUNSELING & DISABILITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS LAVIGNA (OWNER/LCSW)
(386) 788-5021
Entity
Organization
Contact information
Practice address
1635 S RIDGEWOOD AVE STE 225, SOUTH DAYTONA, FL 32119-8478
(386) 788-5021
(386) 788-5021
Mailing address
1635 S RIDGEWOOD AVE STE 225, SOUTH DAYTONA, FL 32119-8478
(386) 788-5021
(386) 788-5021
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
FL
251S00000X
Community/Behavioral Health Agency
Primary
SW9461
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013190700
—
FL
05
—
013191700
—
FL
Enumeration date
01/16/2013
Last updated
05/13/2024
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