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General NPI Number Information
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NPI Number | 1720309115
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Entity Type | Organization
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Legal Business Name | LIFE ENRICHMENT COUNSELING SERVICE LLC
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Dates
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Enumeration Date | 06/20/2010
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 1515 PARK CENTER DR SUITE 2M
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City | ORLANDO
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State | FL
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Zip | 32835-5794
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Country | US
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Telephone | 407-399-6311
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Fax | 407-730-4636
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Provider Business Mailing Address
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Address Line | 7991 CANYON LAKE CIR
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City | ORLANDO
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State | FL
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Zip | 32835-5383
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Country | US
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Telephone | 407-399-6311
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Fax | 407-298-6618
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JEAN AUSTIN-DANNER
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Credential | MSW, LCSW
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Telephone | 407-399-6311
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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 | SW5444
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License Number State | FL
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