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General NPI Number Information
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NPI Number | 1770119513
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Entity Type | Organization
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Legal Business Name | CONNECTED COUNSELING SERVICES ORLANDO INC
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 12890 S JOHN YOUNG PKWY
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City | ORLANDO
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State | FL
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Zip | 32837-3400
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Country | US
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Telephone | 321-300-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 14131 ISLAMORADA DR
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City | ORLANDO
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State | FL
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Zip | 32837-4726
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Country | US
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Telephone | 407-491-3188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TANYA S DOYLE
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Credential | LMFT
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Telephone | 321-300-6840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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