| Consciousness House | |
|
121 E Steele St Orlando FL 32804-3908 | |
| (321) 765-3102 | |
| Not Available |
| Full Name | Consciousness House |
|---|---|
| Speciality | Counselor |
| Location | 121 E Steele St, Orlando, Florida |
| Authorized Official Name and Position | Annie Laurie Maddox (PSYCHOTHERAPIST) |
| Authorized Official Contact | 3217653102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Consciousness House 121 E Steele St Orlando FL 32804-3908 Ph: (407) 462-0845 | Consciousness House 121 E Steele St Orlando FL 32804-3908 Ph: (321) 765-3102 |
| NPI Number | 1164177903 |
|---|---|
| Provider Enumeration Date | 02/21/2022 |
| Last Update Date | 02/21/2022 |
| Certification Date | 02/21/2022 |
| Medicare PECOS PAC ID | 8921446733 |
|---|---|
| Medicare Enrollment ID | O20240329000275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164177903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Annie Laurie Maddox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790935161 PECOS PAC ID: 0749557973 Enrollment ID: I20240329000363 |
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