Provider Demographics
NPI:1699262915
Name:MENTAL PLAYBOOK COUNSELING AND CONSULTING CO.
Entity type:Organization
Organization Name:MENTAL PLAYBOOK COUNSELING AND CONSULTING CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDIN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP/S
Authorized Official - Phone:352-459-5019
Mailing Address - Street 1:5405 DIPLOMAT CIR STE 207
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5620
Mailing Address - Country:US
Mailing Address - Phone:352-459-5019
Mailing Address - Fax:352-358-2040
Practice Address - Street 1:5405 DIPLOMAT CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5620
Practice Address - Country:US
Practice Address - Phone:352-459-5019
Practice Address - Fax:352-358-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC122581041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC12258OtherSTATE LICENSE
FL1316333529OtherNPI NUMBER
SC1316333529OtherJOANNA HEDIN
FL19627OtherSTATE LICENSE