Provider Demographics
NPI:1073963211
Name:FRANK HABERLE DRAKE
Entity Type:Organization
Organization Name:FRANK HABERLE DRAKE
Other - Org Name:WSCU MENTAL HEALTH SERVICES OF CENTRAL FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HABERLE-DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCCC
Authorized Official - Phone:888-401-4012
Mailing Address - Street 1:656 CIMAROSA CT
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-5007
Mailing Address - Country:US
Mailing Address - Phone:888-401-4012
Mailing Address - Fax:407-499-4313
Practice Address - Street 1:213 S DILLARD ST
Practice Address - Street 2:SUITE 320
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3522
Practice Address - Country:US
Practice Address - Phone:407-499-4794
Practice Address - Fax:407-749-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-19
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFH0815-2164101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty