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General NPI Number Information
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NPI Number | 1740673052
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Entity Type | Organization
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Legal Business Name | INNERWORKS COUNSELING LLC
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 612 E COLONIAL DR STE 390
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City | ORLANDO
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State | FL
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Zip | 32803-4650
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Country | US
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Telephone | 407-468-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 1622 ARBOR PARK DR
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City | WINTER PARK
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State | FL
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Zip | 32789-2099
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Country | US
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Telephone | 407-468-5577
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | MS. CARLA IMELDA FISCHER
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Credential | LMHC
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Telephone | 407-468-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | #5654
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License Number State | FL
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