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General NPI Number Information
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NPI Number | 1598192536
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Entity Type | Organization
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Legal Business Name | THE HOWARD PHILLIPS CENTER FOR CHILDREN & FAMILIES
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Dates
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Enumeration Date | 10/05/2013
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Last Update Date | 10/05/2013
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Provider Practice Location Address
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Address Line | 601 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32805-6203
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Country | US
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Telephone | 407-317-7430
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Fax |
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Provider Business Mailing Address
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Address Line | 335 FAIRFIELD DR
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City | SANFORD
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State | FL
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Zip | 32771-6829
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH SUPERVISOR
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Name | SUSAN JOSEPHSON
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Credential |
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Telephone | 407-317-7430
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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 | SW 11027
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License Number State | FL
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