Provider Demographics
NPI:1689810954
Name:DELERME, PATRICK (MA/CMHP)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:DELERME
Suffix:
Gender:M
Credentials:MA/CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SOUTH ORANGE AVENUE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801
Mailing Address - Country:US
Mailing Address - Phone:407-792-5896
Mailing Address - Fax:407-347-4100
Practice Address - Street 1:121 SOUTH ORANGE AVENUE
Practice Address - Street 2:SUITE 1500
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801
Practice Address - Country:US
Practice Address - Phone:407-792-5896
Practice Address - Fax:407-347-4100
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor