Provider Demographics
NPI:1578010336
Name:COFFEE AND CHANGE COUNSELING
Entity Type:Organization
Organization Name:COFFEE AND CHANGE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHINES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, MS
Authorized Official - Phone:407-701-5990
Mailing Address - Street 1:119 NANDINA TER
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6184
Mailing Address - Country:US
Mailing Address - Phone:407-701-5990
Mailing Address - Fax:
Practice Address - Street 1:119 NANDINA TER
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6184
Practice Address - Country:US
Practice Address - Phone:407-701-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty