Provider Demographics
NPI:1558816942
Name:ADAPTABILITY COUNSELING
Entity Type:Organization
Organization Name:ADAPTABILITY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:P
Authorized Official - Last Name:JACK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:407-325-0729
Mailing Address - Street 1:1850 LEE RD SUITE 220
Mailing Address - Street 2:LEE WORLD CENTER
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2115
Mailing Address - Country:US
Mailing Address - Phone:407-325-0729
Mailing Address - Fax:321-316-4863
Practice Address - Street 1:1850 LEE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2115
Practice Address - Country:US
Practice Address - Phone:407-325-0729
Practice Address - Fax:321-316-4863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8933251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL076729800Medicaid