Healthcare Provider Details

I. General information

NPI: 1154582302
Provider Name (Legal Business Name): CHILDREN & FAMILY COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4630 S KIRKMAN RD # 824
ORLANDO FL
32811-2833
US

IV. Provider business mailing address

4630 S KIRKMAN RD # 824
ORLANDO FL
32811-2833
US

V. Phone/Fax

Practice location:
  • Phone: 407-760-1034
  • Fax:
Mailing address:
  • Phone: 407-760-1034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. KOREEN N LIBURD
Title or Position: SOCIAL WORKER
Credential: MSW, RCSW INTERN
Phone: 407-760-1034