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General NPI Number Information
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NPI Number | 1083030878
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Entity Type | Organization
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Legal Business Name | JOURNEY TREE COUNSELING LLC
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 511 N MAITLAND AVE STE 1
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City | MAITLAND
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State | FL
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Zip | 32751-4421
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Country | US
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Telephone | 321-346-8606
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Fax |
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Provider Business Mailing Address
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Address Line | 511 N MAITLAND AVE STE 1
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City | MAITLAND
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State | FL
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Zip | 32751-4421
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Country | US
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Telephone | 321-346-8606
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | LISA OLIVIA HOANG
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Credential | LMHC 11684
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Telephone | 407-350-7956
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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 | MHC 11684
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License Number State | FL
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