Healthcare Provider Details

I. General information

NPI: 1750213930
Provider Name (Legal Business Name): METELL BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W FAIRBANKS AVE STE 203
WINTER PARK FL
32789-4547
US

IV. Provider business mailing address

2020 W FAIRBANKS AVE STE 203
WINTER PARK FL
32789-4547
US

V. Phone/Fax

Practice location:
  • Phone: 407-379-2800
  • Fax:
Mailing address:
  • Phone: 407-379-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES METELLUS
Title or Position: MANAGER
Credential: LCSW
Phone: 407-379-2800