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General NPI Number Information
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NPI Number | 1295036069
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA COUNSELING CENTER
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 501 S BOLIVAR ST
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City | CHATTAHOOCHEE
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State | FL
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Zip | 32324-1347
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Country | US
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Telephone | 850-363-1062
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Fax |
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Provider Business Mailing Address
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Address Line | 1953 CHARLAIS ST
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City | TALLAHASSEE
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State | FL
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Zip | 32317-9546
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Country | US
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Telephone | 850-363-1062
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. SHERRY L LANGE
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Credential |
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Telephone | 850-363-1062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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