| Integrated Life Counseling And Behavior Services | |
|
200 Waymont Ct Ste 126-10 Lake Mary FL 32746-3413 | |
| (407) 488-7927 | |
| (407) 603-0414 |
| Full Name | Integrated Life Counseling And Behavior Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 200 Waymont Ct Ste 126-10, Lake Mary, Florida |
| Authorized Official Name and Position | Anacarolina Vaughn (OWNER) |
| Authorized Official Contact | 3218481916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Life Counseling And Behavior Services 1175 2nd Pl Longwood FL 32750-3029 Ph: (321) 848-1916 | Integrated Life Counseling And Behavior Services 200 Waymont Ct Ste 126-10 Lake Mary FL 32746-3413 Ph: (407) 488-7927 |
| NPI Number | 1679030084 |
|---|---|
| Provider Enumeration Date | 02/22/2019 |
| Last Update Date | 10/20/2021 |
| Certification Date | 10/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679030084 | NPI | - | NPPES |
| 021251000 | Other | FL | 39- MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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