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General NPI Number Information
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NPI Number | 1164172789
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Entity Type | Organization
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Legal Business Name | SOJOURNER COUNSELING LLC
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Dates
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Enumeration Date | 03/26/2022
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Last Update Date | 03/26/2022
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Provider Practice Location Address
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Address Line | 3222 CORRINE DR STE J
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City | ORLANDO
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State | FL
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Zip | 32803-2217
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Country | US
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Telephone | 407-720-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 OHIO DR
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City | ORLANDO
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State | FL
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Zip | 32803-2028
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Country | US
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Telephone | 407-720-9906
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. LISA SOJOURNER
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Credential |
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Telephone | 407-720-9906
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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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