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NPI Code Detail

MEDICARE: INNER LIGHT COUNSELING LLC

MEDICARE: INNER LIGHT COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH7419FL

General Provider Information

NPI Number : 1427458207
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER LIGHT COUNSELING LLC
Provider Business Mailing Address
First Line : 8857 LAKE FLORENCE BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32818-8931
Country : US
Telephone Number : 321-594-7633
Fax Number : 407-696-4831
Provider Business Practice Location Address
First Line : 650 MAITLAND AVE
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32701-6862
Country : US
Telephone Number : 321-594-7633
Fax Number : 407-696-4831
Authorized Official
Title or Position : PRESIDENT
Name : MRS. PAMELA GOLDSMITH
Credential : MA LMHC
Telephone Number : 321-594-7633
Provider Enumeration Date : 08/28/2014
Last Update Date : 08/28/2014

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Directions to “INNER LIGHT COUNSELING LLC ” Practice Location

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