Provider Demographics
NPI:1477856995
Name:AP FAMILY LIFE EDUCATIONAL COUNSELING & CONSULTING SVS INC
Entity type:Organization
Organization Name:AP FAMILY LIFE EDUCATIONAL COUNSELING & CONSULTING SVS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEMBLETON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:850-763-8100
Mailing Address - Street 1:PO BOX 977
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32402-0977
Mailing Address - Country:US
Mailing Address - Phone:850-763-8100
Mailing Address - Fax:
Practice Address - Street 1:5 MIRACLE STRIP LOOP STE 14
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-8410
Practice Address - Country:US
Practice Address - Phone:850-763-8100
Practice Address - Fax:850-763-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8956101Y00000X, 101YM0800X, 102L00000X, 103K00000X, 103T00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty