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General NPI Number Information
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NPI Number | 1063786333
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Entity Type | Organization
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Legal Business Name | LIFE ENHANCEMENT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 6200 METROWEST BLVD SUITE 201-H
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City | ORLANDO
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State | FL
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Zip | 32835-7636
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Country | US
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Telephone | 407-620-7855
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Fax | 407-286-6465
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Provider Business Mailing Address
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Address Line | PO BOX 341
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City | GOTHA
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State | FL
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Zip | 34734-0341
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Country | US
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Telephone | 407-620-7855
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Fax | 407-286-6465
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | YOLANDA BRAILEY
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Credential | LMHC
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Telephone | 407-620-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH9639
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License Number State | FL
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