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General NPI Number Information
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NPI Number | 1962959940
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Entity Type | Organization
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Legal Business Name | ABUNDANCE, MENTAL HEALTH COUNSELING LLC
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 32313 BROADWAY ST, SUITE 310
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City | SEBRING
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State | FL
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Zip | 33870
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Country | US
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Telephone | 863-446-2853
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Fax |
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Provider Business Mailing Address
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Address Line | 32313 BROADWAY ST. SUITE 310
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City | SEBRING
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State | FL
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Zip | 33870
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Country | US
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Telephone | 863-446-2853
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. AMANDA ELAINE HOLLYWOOD
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Credential | L.M.H.C.
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Telephone | 863-446-2853
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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 | MH12709
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License Number State | FL
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