Central Florida Psychotherapy Services LLC
Social Worker, Clinical in Lakeland, FL. Organization (NPI-2).
NPI number1689286809
StatusActive
Last updated in NPPESAug 19, 2020
Details
- NPI
- 1689286809
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Florida Psychotherapy Services LLC
- Organization subpart
- No
- Enumeration date
- Aug 19, 2020
- Certification date
- Aug 19, 2020
- Last updated
- Aug 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Other names
- Psychotherapy Services Of Newlight (Doing Business As)
Practice location
5302 S Florida Ave Ste 200Lakeland, FL 33813-4922
Phone 853-602-7001 · Fax 863-583-8585
Mailing address
5302 S Florida Ave Ste 203Lakeland, FL 33813-4910
Phone 863-602-7001 · Fax 863-583-8585
Authorized official
Jomon Thekkethottiyil
Owner
3304163867
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