Provider Demographics
NPI:1679020218
Name:MCW MD- RESILIENCE COUNSELING LLC
Entity Type:Organization
Organization Name:MCW MD- RESILIENCE COUNSELING LLC
Other - Org Name:RESILIENCE COUNSELING CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-977-4335
Mailing Address - Street 1:1000 EXECUTIVE DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8140
Mailing Address - Country:US
Mailing Address - Phone:407-977-4335
Mailing Address - Fax:407-977-4370
Practice Address - Street 1:1000 EXECUTIVE DR
Practice Address - Street 2:SUITE 7
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8140
Practice Address - Country:US
Practice Address - Phone:407-977-4335
Practice Address - Fax:407-977-4370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty