Provider Demographics
NPI:1770119513
Name:CONNECTED COUNSELING SERVICES ORLANDO INC
Entity type:Organization
Organization Name:CONNECTED COUNSELING SERVICES ORLANDO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:321-300-6840
Mailing Address - Street 1:14131 ISLAMORADA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4726
Mailing Address - Country:US
Mailing Address - Phone:407-491-3188
Mailing Address - Fax:
Practice Address - Street 1:12890 S JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-3400
Practice Address - Country:US
Practice Address - Phone:321-300-6840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)