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General NPI Number Information
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NPI Number | 1073295259
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Entity Type | Organization
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Legal Business Name | ONE MORE LIGHT COUNSELING & WELLNESS LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 01/27/2024
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Provider Practice Location Address
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Address Line | 819 W MAIN ST STE A
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City | TAVARES
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State | FL
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Zip | 32778-3131
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Country | US
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Telephone | 321-800-8439
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Fax |
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Provider Business Mailing Address
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Address Line | 201 WINDEMERE AVE
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City | EUSTIS
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State | FL
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Zip | 32726-5536
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Country | US
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Telephone | 321-800-8439
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JOSEPH RYAN CAGGIANO
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Credential | MSFP, MSW
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Telephone | 321-800-8439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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