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General NPI Number Information
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NPI Number | 1720397185
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Entity Type | Organization
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Legal Business Name | ST. LUKES UNITED METHODIST CHURCH, THE COMMUNITY COUNSELING CENTER
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 4851 S APOPKA-VINELAND RD.
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-876-4991
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Fax | 407-876-5273
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Provider Business Mailing Address
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Address Line | 4851 S APOPKA-VINELAND RD.
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-876-4991
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Fax | 407-876-5273
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Authorized Official
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Title or Position | DIRECTOR, THE COMMUNITY COUNSELING
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Name | DR. JOANNE CHRISTINE MACPHERSON
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Credential | L.M.H.C.
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Telephone | 407-876-4991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MH3582
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH3582
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH3582
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MH3582
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License Number State | FL
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