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General NPI Number Information
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NPI Number | 1366501512
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Entity Type | Organization
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Legal Business Name | VISTA EMPLOYEE ASSISTANCE & COUNSELING INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 TIMBERLACHEN CIR SUITE 201
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City | LAKE MARY
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State | FL
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Zip | 32746-6124
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Country | US
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Telephone | 407-324-9440
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Fax | 407-330-5244
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Provider Business Mailing Address
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Address Line | 101 TIMBERLACHEN CIR SUITE 201
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City | LAKE MARY
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State | FL
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Zip | 32746-6124
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Country | US
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Telephone | 407-324-9440
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Fax | 407-330-5244
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Authorized Official
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Title or Position | OWNER
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Name | MS. CYNTHIA N HERZOG
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Credential | LCSW
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Telephone | 407-324-9440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW002024
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License Number State | FL
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