MEDICARE: AFFIRMING COUNSELING AND CONSULTING 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
1	101YM0800X	Mental Health Counselor	MH6723	FL

General Provider Information

NPI Number	:	1437597234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFIRMING COUNSELING AND CONSULTING LLC

Provider Business Mailing Address
First Line	:	1850 LEE RD STE 300
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2107
Country	:	US
Telephone Number	:	407-470-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 LEE RD STE 300
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2107
Country	:	US
Telephone Number	:	407-470-8899
Fax Number	:

Authorized Official
Title or Position	:	LMHC
Name	:	MS. KATHY B BOOKER
Credential	:	MH6723
Telephone Number	:	407-454-4611

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	06/13/2013

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