Provider Demographics
NPI:1336917475
Name:ESSENCE OF LOVE THERAPY LLC
Entity Type:Organization
Organization Name:ESSENCE OF LOVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:SHERNITA
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-378-0393
Mailing Address - Street 1:208 OAKFIELD DR UNIT 290
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5707
Mailing Address - Country:US
Mailing Address - Phone:813-378-0393
Mailing Address - Fax:
Practice Address - Street 1:208 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5707
Practice Address - Country:US
Practice Address - Phone:904-352-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)