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General NPI Number Information
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NPI Number | 1093298457
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Entity Type | Organization
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Legal Business Name | MELTING WALLS FAMILY CONSULTANTS
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 1100 TOWN PLAZA CT STE 1010
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-6231
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Country | US
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Telephone | 407-953-2497
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Fax | 407-359-2756
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Provider Business Mailing Address
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Address Line | 1809 E BROADWAY ST STE 355
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City | OVIEDO
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State | FL
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Zip | 32765-8597
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Country | US
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Telephone | 407-953-2497
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Fax | 407-359-2756
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Authorized Official
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Title or Position | BUSINESS OPERATIONS
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Name | DR. KEVIN TURNER
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Credential | PHD
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Telephone | 407-953-7927
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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