Provider Demographics
NPI:1578632394
Name:CENTRAL FLORIDA COUNSELING ASSOCIATES, INC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA COUNSELING ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-563-1389
Mailing Address - Street 1:1850 LEE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2104
Mailing Address - Country:US
Mailing Address - Phone:407-301-3460
Mailing Address - Fax:904-592-6621
Practice Address - Street 1:1850 LEE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2104
Practice Address - Country:US
Practice Address - Phone:407-301-3460
Practice Address - Fax:904-592-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW7078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW7078OtherCLINICAL SOCIAL WORKER
1578632394Medicare UPIN
FLSW7078OtherCLINICAL SOCIAL WORKER