Provider Demographics
NPI:1841276243
Name:ORLANDO COUNSELING CENTER FOR CHILDREN FAMILIES AND ADULTS PA
Entity type:Organization
Organization Name:ORLANDO COUNSELING CENTER FOR CHILDREN FAMILIES AND ADULTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-252-3644
Mailing Address - Street 1:2468 BALBOA CT
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2603
Mailing Address - Country:US
Mailing Address - Phone:727-475-2199
Mailing Address - Fax:727-475-2198
Practice Address - Street 1:737 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3502
Practice Address - Country:US
Practice Address - Phone:727-475-2199
Practice Address - Fax:727-475-2198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty