Provider Demographics
NPI:1184822157
Name:DESTINY ADULT & CHILDREN COUNSELING CTR
Entity Type:Organization
Organization Name:DESTINY ADULT & CHILDREN COUNSELING CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:U
Authorized Official - Last Name:OIBO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:352-622-4888
Mailing Address - Street 1:150 SE 17TH ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5178
Mailing Address - Country:US
Mailing Address - Phone:352-622-4888
Mailing Address - Fax:352-694-4884
Practice Address - Street 1:150 SE 17TH ST
Practice Address - Street 2:SUITE 801
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5178
Practice Address - Country:US
Practice Address - Phone:352-622-4888
Practice Address - Fax:352-694-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7369261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)