MEDICARE: INSIDE OUT YOUR VOICE YOUR STORY

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	1041C0700X	Clinical Social Worker
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1558837161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIDE OUT YOUR VOICE YOUR STORY

Provider Business Mailing Address
First Line	:	7726 WINEGARD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7147
Country	:	US
Telephone Number	:	844-711-8336
Fax Number	:

Provider Business Practice Location Address
First Line	:	7726 WINEGARD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7147
Country	:	US
Telephone Number	:	844-711-8336
Fax Number	:

Authorized Official
Title or Position	:	MSW
Name	:	MONIQUE PENA
Credential	:
Telephone Number	:	219-552-8336

Provider Enumeration Date	:	10/22/2018
Last Update Date	:	10/15/2024

Similar Medicare Providers

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Practice Location Address:

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1598755761 — DR. GUSTAVO V. RUIZ-SANTIAGO M.D.
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1295037125 — MRS. JESSICA PIERRE LEMAIRE
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1790216802 — SHANEEN CLARK APRN
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1215417035 — MARTA Y DECLET
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1114575636 — MOSAICO MENTAL HEALTH CENTER CORP
Practice Location Address:

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