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General NPI Number Information
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NPI Number | 1487867982
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Entity Type | Organization
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Legal Business Name | SEMINOLE COMMUNITY MENTAL HEALTH CENTER, INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5713 CREEK DALE DR
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City | ORLANDO
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State | FL
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Zip | 32810-3981
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Country | US
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Telephone | 407-297-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 5713 CREEKDALE DRIVE
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City | ORLANDO
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State | FL
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Zip | 32810
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Country | US
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Telephone | 407-297-1811
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Fax |
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Authorized Official
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Title or Position | CRISIS SUPPORT SPECIALIST
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Name | MS. PHYLLIS CASSANDRA HARRIS
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Credential | MASTER'S DEGREE
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Telephone | 407-321-4357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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