Healthcare Provider Details

I. General information

NPI: 1023277571
Provider Name (Legal Business Name): PRESBYTERIAN COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W PENNSYLVANIA AVE
DELAND FL
32720-3429
US

IV. Provider business mailing address

386 S ATLANTIC AVE # 208
ORMOND BEACH FL
32176-7143
US

V. Phone/Fax

Practice location:
  • Phone: 386-258-1618
  • Fax: 386-253-4215
Mailing address:
  • Phone: 386-258-1618
  • Fax: 386-253-4215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberN13551
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA B WALKER
Title or Position: ADMIN DIRECTOR
Credential:
Phone: 386-258-1618