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General NPI Number Information
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NPI Number | 1194356386
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Entity Type | Organization
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Legal Business Name | MR. ED'S CIRCLE OF TRUST, INC.
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 4404 S. FLORIDA AVE. SUITE 14
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City | LAKELAND
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State | FL
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Zip | 33813-2124
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Country | US
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Telephone | 863-583-4766
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Fax | 850-270-6733
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Provider Business Mailing Address
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Address Line | 4404 S FLORIDA AVE STE 6B
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City | LAKELAND
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State | FL
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Zip | 33813-2124
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Country | US
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Telephone | 863-583-4766
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Fax | 850-270-6733
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. FRANKLIN EDWARD SHOEMAKER
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Credential | LMHC
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Telephone | 863-899-2162
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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 |
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License Number State |
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