Healthcare Provider Details

I. General information

NPI: 1609830801
Provider Name (Legal Business Name): CYNTHIA A GELTZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 LYNDALE BLVD
MAITLAND FL
32751-6522
US

IV. Provider business mailing address

1621 LYNDALE BLVD
MAITLAND FL
32751-6522
US

V. Phone/Fax

Practice location:
  • Phone: 407-620-1488
  • Fax:
Mailing address:
  • Phone: 407-620-1488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8598
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: