Provider Demographics
NPI:1053356741
Name:THE GROUP FOR PSYCHIATRY, PSYCHOLOGY & WELLNESS, LLC
Entity type:Organization
Organization Name:THE GROUP FOR PSYCHIATRY, PSYCHOLOGY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-644-2121
Mailing Address - Street 1:1555 HOWELL BRANCH RD
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1109
Mailing Address - Country:US
Mailing Address - Phone:407-644-2121
Mailing Address - Fax:407-644-2974
Practice Address - Street 1:1555 HOWELL BRANCH RD
Practice Address - Street 2:SUITE B-4
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1109
Practice Address - Country:US
Practice Address - Phone:407-644-2121
Practice Address - Fax:407-644-2974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45252Medicare ID - Type Unspecified