Healthcare Provider Details

I. General information

NPI: 1467745919
Provider Name (Legal Business Name): CHARLES ENGLISH, PH.D. & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 LEE ROAD SUITE 300
WINTER PARK FL
32789-2107
US

IV. Provider business mailing address

1850 LEE ROAD SUITE 300
WINTER PARK FL
32789-2107
US

V. Phone/Fax

Practice location:
  • Phone: 407-740-8899
  • Fax: 407-740-8771
Mailing address:
  • Phone: 407-740-8899
  • Fax: 407-740-8771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH2166
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberMH2166
License Number StateFL

VIII. Authorized Official

Name: MR. CHARLES W ENGLISH
Title or Position: OWNER/DIRECTOR
Credential: PH.D.
Phone: 407-740-8899