Healthcare Provider Details

I. General information

NPI: 1992581649
Provider Name (Legal Business Name): ONE MORE CHILD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 SIKES BLVD
LAKELAND FL
33815-4499
US

IV. Provider business mailing address

1015 SIKES BLVD
LAKELAND FL
33815-4499
US

V. Phone/Fax

Practice location:
  • Phone: 352-978-2988
  • Fax:
Mailing address:
  • Phone: 352-978-2988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHLEEN C PRACHT
Title or Position: CLINICAL DIRECTOR
Credential: PHD, NCC, LMHC
Phone: 352-978-2988