Healthcare Provider Details

I. General information

NPI: 1477856995
Provider Name (Legal Business Name): AP FAMILY LIFE EDUCATIONAL COUNSELING & CONSULTING SVS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 JAZZ DR
PANAMA CITY FL
32405-4906
US

IV. Provider business mailing address

PO BOX 977
PANAMA CITY FL
32402-0977
US

V. Phone/Fax

Practice location:
  • Phone: 850-296-8350
  • Fax: 872-246-8210
Mailing address:
  • Phone: 850-296-8350
  • Fax: 872-246-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH8956
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8956
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberMH8956
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberMH8956
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberMH8956
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH8956
License Number StateFL

VIII. Authorized Official

Name: DR. ANITA PEMBLETON
Title or Position: PRESIDENT/CEO
Credential: PHD
Phone: 850-763-8100