Healthcare Provider Details

I. General information

NPI: 1780492215
Provider Name (Legal Business Name): KAPWA MUSIC THERAPY AND COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 EDGEWATER DR
ORLANDO FL
32804-6306
US

IV. Provider business mailing address

1137 EDGEWATER DR
ORLANDO FL
32804-6306
US

V. Phone/Fax

Practice location:
  • Phone: 407-720-6381
  • Fax:
Mailing address:
  • Phone: 407-720-6381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOANNA DEROSA
Title or Position: OWNER
Credential: LMHC
Phone: 407-720-6381