| Life In Full Bloom Counseling, Llc | |
|
711 N Orlando Ave Ste 203 Maitland FL 32751-4403 | |
| (407) 513-2589 | |
| (407) 637-2823 |
| Full Name | Life In Full Bloom Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 711 N Orlando Ave Ste 203, Maitland, Florida |
| Authorized Official Name and Position | Ashley Noel Valence (SOLE MEMBER) |
| Authorized Official Contact | 4075132589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life In Full Bloom Counseling, Llc 711 N Orlando Ave Ste 203 Maitland FL 32751-4403 Ph: (407) 513-2589 | Life In Full Bloom Counseling, Llc 711 N Orlando Ave Ste 203 Maitland FL 32751-4403 Ph: (407) 513-2589 |
| NPI Number | 1134793094 |
|---|---|
| Provider Enumeration Date | 05/16/2021 |
| Last Update Date | 05/16/2021 |
| Certification Date | 05/16/2021 |
| Medicare PECOS PAC ID | 8426493487 |
|---|---|
| Medicare Enrollment ID | O20240229000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134793094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ashley Noel Valence |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265025043 PECOS PAC ID: 3971948936 Enrollment ID: I20240229001106 |
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