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General NPI Number Information
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NPI Number | 1821455916
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTER & HUMAN SEXUALITY INSTITUTE
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 2450 TIM GAMBLE PLACE 2ND FLOOR
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City | TALLAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone | 850-656-2100
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Fax | 850-656-2130
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Provider Business Mailing Address
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Address Line | 2450 TIM GAMBLE PLACE 2ND FLOOR
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City | TALLAHASSEE
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State | FL
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Zip | 32308
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Country | US
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Telephone | 850-656-2100
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Fax | 850-656-2130
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINDA HUMPHRIES
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Credential | MSW, LCSW, PHD
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Telephone | 850-656-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | SW2363
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License Number State | FL
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