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General NPI Number Information
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NPI Number | 1306112701
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Entity Type | Organization
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Legal Business Name | PATHWAYS TO FREEDOM COUNSELING CENTER
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 301 N HIGHWAY 27 UNIT E
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City | CLERMONT
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State | FL
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Zip | 34711-2447
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Country | US
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Telephone | 352-978-6383
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Fax | 352-536-2018
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Provider Business Mailing Address
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Address Line | 301 N HIGHWAY 27 UNIT E
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City | CLERMONT
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State | FL
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Zip | 34711-2447
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Country | US
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Telephone | 352-978-6383
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Fax | 352-536-2018
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHIRLEY JEAN SMITH
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Credential | L.M.H.C.
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Telephone | 352-978-6383
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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 | MH8709
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License Number State | FL
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