Provider Demographics
NPI:1356935381
Name:ELLIPSIS COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:ELLIPSIS COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-433-3992
Mailing Address - Street 1:978 CAMBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-2941
Mailing Address - Country:US
Mailing Address - Phone:407-906-1224
Mailing Address - Fax:
Practice Address - Street 1:4700 MILLENIA BLVD STE 175
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-6015
Practice Address - Country:US
Practice Address - Phone:407-433-3992
Practice Address - Fax:407-910-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-20
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty