Healthcare Provider Details

I. General information

NPI: 1487154381
Provider Name (Legal Business Name): SIMPLE LIFE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 02/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 CLARK ST STE 1030
OVIEDO FL
32765-9270
US

IV. Provider business mailing address

1520 CROSSWIND CIR
ORLANDO FL
32825-8865
US

V. Phone/Fax

Practice location:
  • Phone: 407-619-0034
  • Fax:
Mailing address:
  • Phone: 407-619-0034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberMH15108
License Number StateFL

VIII. Authorized Official

Name: JANELLE RAMDASS
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 407-619-0034