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General NPI Number Information
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NPI Number | 1720901101
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Entity Type | Organization
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Legal Business Name | QIV TECH ACADEMY, INC
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 2301 LONGLEAF BLVD STE 300
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City | LAKE WALES
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State | FL
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Zip | 33859-2542
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Country | US
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Telephone | 863-288-1421
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 LONGLEAF BLVD STE 300
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City | LAKE WALES
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State | FL
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Zip | 33859-2542
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Country | US
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Telephone | 863-288-1421
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. DANETTA POWELL
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Credential |
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Telephone | 863-288-1421
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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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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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