Provider Demographics
NPI:1578760393
Name:TRUE VINE CONSULTANTS
Entity Type:Organization
Organization Name:TRUE VINE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:407-532-7407
Mailing Address - Street 1:2035 ERVING CIR
Mailing Address - Street 2:#3-111
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-6824
Mailing Address - Country:US
Mailing Address - Phone:407-532-7407
Mailing Address - Fax:407-522-6147
Practice Address - Street 1:2035 ERVING CIR
Practice Address - Street 2:#3-111
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-6824
Practice Address - Country:US
Practice Address - Phone:407-532-7407
Practice Address - Fax:407-522-6147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW62591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty