=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396325155
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WSI LEARNING CENTERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2021
-----------------------------------------------------
Last Update Date | 05/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8317 FRONT BEACH RD STE 23
-----------------------------------------------------
City | PANAMA CITY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32407-4893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-919-3619
-----------------------------------------------------
Fax | 850-254-0827
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8317 FRONT BEACH RD STE 23
-----------------------------------------------------
City | PANAMA CITY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32407-4893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-866-0441
-----------------------------------------------------
Fax | 850-254-0827
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BARBARA ELLIS-WOROCH
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 850-919-3619
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------