MEDICARE: A NEW PATH IN CHRISTIAN COUSELING,INC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2683822	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629516398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A NEW PATH IN CHRISTIAN COUSELING,INC

Provider Business Mailing Address
First Line	:	1140 S SEMORAN BLVD STE C
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-1459
Country	:	US
Telephone Number	:	407-271-8990
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 S SEMORAN BLVD STE C
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-1459
Country	:	US
Telephone Number	:	407-271-8990
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. YOLANDA I JOHNSON
Credential	:
Telephone Number	:	407-271-8990

Provider Enumeration Date	:	02/02/2017
Last Update Date	:	02/02/2017

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