Healthcare Provider Details

I. General information

NPI: 1487486999
Provider Name (Legal Business Name): POSSIBILITY JUNCTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N RONALD REAGAN BLVD STE 309
LONGWOOD FL
32750-5902
US

IV. Provider business mailing address

300 N RONALD REAGAN BLVD STE 309
LONGWOOD FL
32750-5902
US

V. Phone/Fax

Practice location:
  • Phone: 689-249-1809
  • Fax: 407-573-7557
Mailing address:
  • Phone: 689-249-1809
  • Fax: 407-573-7557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA BEVERLY CARTER
Title or Position: CLINICIAN
Credential: MS, LMHC, MCAP
Phone: 689-249-1809