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General NPI Number Information
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NPI Number | 1093172389
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Entity Type | Organization
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Legal Business Name | CONNECTING WELL
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Dates
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Enumeration Date | 01/18/2016
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Last Update Date | 01/18/2016
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Provider Practice Location Address
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Address Line | 5728 MAJOR BLVD STE 506
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City | ORLANDO
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State | FL
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Zip | 32819-7970
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Country | US
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Telephone | 407-351-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 8654 VISTA PINE CT
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City | ORLANDO
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State | FL
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Zip | 32836-6307
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Country | US
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Telephone | 407-351-1010
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANCY LANGFORD
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Credential | M.ED.
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Telephone | 407-351-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT959
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH2413
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License Number State | FL
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