Provider Demographics
NPI:1407524085
Name:PHC MENTAL HEALTH COUNSELING
Entity Type:Organization
Organization Name:PHC MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PARICK
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-920-9717
Mailing Address - Street 1:729 LANGSTON CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6221
Mailing Address - Country:US
Mailing Address - Phone:407-920-9717
Mailing Address - Fax:
Practice Address - Street 1:2260 GLENWOOD DR
Practice Address - Street 2:OPTIONAL
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3279
Practice Address - Country:US
Practice Address - Phone:407-920-9717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center