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1850 Lee Road Suite 300 Winter Park FL 32789-2107 | |
| (407) 740-8899 | |
| (407) 740-8771 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1850 Lee Road, Winter Park, Florida |
| Authorized Official Name and Position | Charles W English (OWNER/DIRECTOR) |
| Authorized Official Contact | 4077408899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1850 Lee Road Suite 300 Winter Park FL 32789-2107 Ph: (407) 740-8899 | 1850 Lee Road Suite 300 Winter Park FL 32789-2107 Ph: (407) 740-8899 |
| NPI Number | 1467745919 |
|---|---|
| Provider Enumeration Date | 05/17/2011 |
| Last Update Date | 08/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467745919 | NPI | - | NPPES |
| 000941200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH2166 (Florida) | Primary |
| 251B00000X | Case Management | MH2166 (Florida) | Secondary |
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