Provider Demographics
NPI:1346547262
Name:MAITLAND COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:MAITLAND COUNSELING CENTER LLC
Other - Org Name:VIRGINIA CURBELO LMHC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CURBELO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-415-7119
Mailing Address - Street 1:668 N ORLANDO AVE
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4473
Mailing Address - Country:US
Mailing Address - Phone:407-415-7119
Mailing Address - Fax:
Practice Address - Street 1:668 N ORLANDO AVE
Practice Address - Street 2:SUITE 1020
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4473
Practice Address - Country:US
Practice Address - Phone:407-415-7119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8632251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health