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General NPI Number Information
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NPI Number | 1851845523
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Entity Type | Organization
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Legal Business Name | AGAPE THERAPY INSTITUTE, CORP.
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 510 CHRISTOR PL
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City | ORLANDO
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State | FL
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Zip | 32803-5332
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Country | US
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Telephone | 407-900-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 510 CHRISTOR PL
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City | ORLANDO
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State | FL
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Zip | 32803-5332
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Country | US
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Telephone | 407-900-8633
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. SUSAN BETH BEARDEN
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Credential | MS, LMHC-QS, LMFT-QS
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Telephone | 407-900-8633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13438
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License Number State | FL
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