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General NPI Number Information
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NPI Number | 1891923876
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Entity Type | Organization
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Legal Business Name | CHARIS COUNSELING CENTER
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 1543 LAKE BALDWIN LN SUITE B
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City | ORLANDO
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State | FL
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Zip | 32814-6695
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Country | US
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Telephone | 407-894-5202
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Fax |
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Provider Business Mailing Address
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Address Line | 1543 LAKE BALDWIN LN SUITE B
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City | ORLANDO
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State | FL
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Zip | 32814-6695
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Country | US
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Telephone | 407-894-5202
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES KELLER
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Credential |
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Telephone | 407-894-5202
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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 | 8431
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License Number State | FL
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