Provider Demographics
NPI:1003570888
Name:TRANQUIL WATERS COUNSELING LLC
Entity Type:Organization
Organization Name:TRANQUIL WATERS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN-MARIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MIGLIONICO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-738-9408
Mailing Address - Street 1:12617 NARCOOSSEE ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832
Mailing Address - Country:US
Mailing Address - Phone:407-738-9408
Mailing Address - Fax:407-738-9408
Practice Address - Street 1:12617 NARCOOSSEE ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832
Practice Address - Country:US
Practice Address - Phone:407-738-9408
Practice Address - Fax:407-738-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty