Organization · NPI-2

1 Village 1 Child

Community/Behavioral Health · Apopka, FL

NPI number1215345327

StatusActive

Last updated in NPPESFeb 5, 2015

Details

NPI: 1215345327
Entity type: Organization (NPI-2)
Legal business name: 1 Village 1 Child
Organization subpart: No
Enumeration date: Aug 1, 2014
Last updated: Feb 5, 2015

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
101Y00000X	Counselor	–	–
101YM0800X	Counselor, Mental Health	–	–
103T00000X	Psychologist	–	–
103TC0700X	Psychologist, Clinical	–	–
103TC2200X	Psychologist, Clinical Child & Adolescent	–	–
103TF0000X	Psychologist, Family	–	–
103TP2701X	Psychologist, Group Psychotherapy	–	–
104100000X	Social Worker	–	–
1041C0700X	Social Worker, Clinical	–	–
106H00000X	Marriage & Family Therapist	–	–
102X00000X	Poetry Therapist	–	–

Practice location

1257 Reagans Reserve Blvd
Apopka, FL 32712-3008

Phone 321-209-3259

Mailing address

Po Box 308
Gotha, FL 34734-0308

Authorized official

Keith Daly
Owner
3212093259

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