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General NPI Number Information
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NPI Number | 1487140315
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Entity Type | Organization
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Legal Business Name | REAL PEOPLE THERAPY LLC
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 7350 FUTURES DR STE 18
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City | ORLANDO
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State | FL
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Zip | 32819-9084
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Country | US
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Telephone | 407-334-4748
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Fax | 321-236-7097
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Provider Business Mailing Address
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Address Line | 5201 MILL STREAM RD
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City | OCOEE
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State | FL
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Zip | 34761-8121
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Country | US
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Telephone | 407-334-4748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AMANDA SECRAN MANSILLA
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Credential | LCSW
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Telephone | 407-334-4748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW11968
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License Number State | FL
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