Provider Demographics
NPI:1386602415
Name:CHILD ADVOCACY CENTER
Entity type:Organization
Organization Name:CHILD ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LMFT
Authorized Official - Phone:352-376-9161
Mailing Address - Street 1:PO BOX 1128
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32602-1128
Mailing Address - Country:US
Mailing Address - Phone:352-376-9161
Mailing Address - Fax:352-376-9165
Practice Address - Street 1:2720 NE 20TH WAY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3351
Practice Address - Country:US
Practice Address - Phone:352-376-9161
Practice Address - Fax:352-376-9165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty