Provider Demographics
NPI:1104965268
Name:A BETTER THERAPY, INC.
Entity type:Organization
Organization Name:A BETTER THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-774-2284
Mailing Address - Street 1:740 FLORIDA CENTRAL PKWY
Mailing Address - Street 2:#2008
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-7651
Mailing Address - Country:US
Mailing Address - Phone:407-774-2284
Mailing Address - Fax:407-774-2285
Practice Address - Street 1:740 FLORIDA CENTRAL PKWY
Practice Address - Street 2:#2008
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-7651
Practice Address - Country:US
Practice Address - Phone:407-774-2284
Practice Address - Fax:407-774-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11048101YM0800X
FL015664400251S00000X
FLMH7827251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL927200OtherWELLCARE
FL277791OtherAMERIGROUP PROVIDER NO.
FL015664400Medicaid