Healthcare Provider Details

I. General information

NPI: 1235554783
Provider Name (Legal Business Name): ONE MORE CHILD SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 SIKES BLVD.
LAKELAND FL
33815
US

IV. Provider business mailing address

1015 SIKES BLVD.
LAKELAND FL
33815
US

V. Phone/Fax

Practice location:
  • Phone: 863-687-8811
  • Fax: 863-682-3157
Mailing address:
  • Phone: 863-687-8811
  • Fax: 863-682-3157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number100035936
License Number StateFL

VIII. Authorized Official

Name: MRS. MELISSA B. POOLE
Title or Position: SENIOR VP OF INTERVENTION SERVICES
Credential: LMHC, FL-CBA
Phone: 904-349-1954