Provider Demographics
NPI:1083218416
Name:THE PROGRESSIVE BEAT, LLC
Entity Type:Organization
Organization Name:THE PROGRESSIVE BEAT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-217-7153
Mailing Address - Street 1:PO BOX 560344
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32856-0344
Mailing Address - Country:US
Mailing Address - Phone:321-217-7153
Mailing Address - Fax:
Practice Address - Street 1:315 N WYMORE RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2822
Practice Address - Country:US
Practice Address - Phone:321-217-7153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty