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General NPI Number Information
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NPI Number | 1225430036
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Entity Type | Organization
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Legal Business Name | L&M'S COMPLETE CARE MENTAL HEALTH COUNSELING, INC.
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 750 S ORANGE BLOSSOM TRL
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City | ORLANDO
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State | FL
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Zip | 32805-3118
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Country | US
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Telephone | 407-756-2228
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Fax |
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Provider Business Mailing Address
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Address Line | 3536 LAKE TINY CIR
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City | ORLANDO
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State | FL
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Zip | 32818-2297
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Country | US
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Telephone | 407-756-2228
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Fax | 407-250-6037
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | LUCNER METELLUS
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Credential | M.A.
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Telephone | 407-756-2228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | IMH 10469
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License Number State | FL
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