Healthcare Provider Details

I. General information

NPI: 1154554939
Provider Name (Legal Business Name): RESILIENCE COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1759 W BROADWAY ST SUITE 3
OVIEDO FL
32765-8128
US

IV. Provider business mailing address

1759 W BROADWAY ST SUITE 3
OVIEDO FL
32765-8128
US

V. Phone/Fax

Practice location:
  • Phone: 407-977-4335
  • Fax: 407-977-4370
Mailing address:
  • Phone: 407-977-4335
  • Fax: 407-977-4370

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
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAREN PETERS
Title or Position: PRESIDENT/CEO
Credential: LMHC, NCC
Phone: 407-977-4335