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General NPI Number Information
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NPI Number | 1609113141
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Entity Type | Organization
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Legal Business Name | MULTICULTURAL COUNSELING CENTERS
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 1850 LEE RD STE 300
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City | WINTER PARK
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State | FL
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Zip | 32789-2107
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Country | US
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Telephone | 407-740-8899
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Fax | 407-740-8771
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Provider Business Mailing Address
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Address Line | 1850 LEE RD STE 300
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City | WINTER PARK
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State | FL
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Zip | 32789-2107
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Country | US
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Telephone | 407-740-8899
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Fax | 407-740-8771
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. CHARLES WESLEY ENLISH
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Credential | PH. D.
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Telephone | 407-740-8899
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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 | MH2166
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License Number State | FL
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