Healthcare Provider Details

I. General information

NPI: 1821030149
Provider Name (Legal Business Name): THE RIPPLE EFFECT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 COLUMBIA ST
ORLANDO FL
32806-1007
US

IV. Provider business mailing address

425 COLUMBIA ST
ORLANDO FL
32806-1007
US

V. Phone/Fax

Practice location:
  • Phone: 407-770-6710
  • Fax: 407-447-1508
Mailing address:
  • Phone: 407-770-6710
  • Fax: 407-447-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: BOB DECKER
Title or Position: EXECUTIVE DIRECTOR
Credential: LMHC
Phone: 407-770-6710