# PATH OF CHANGE COUNSELING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023922143
- **Authorized official:** COURTNEY KIANA HAYNES LMHC (MEMBER)
- **Authorized official phone:** (904) 250-2436

## Contact information

- **Practice address:** 2267 COVENTRY DR, WINTER PARK, FL 32792-2214
- **Practice address phone:** (904) 250-2436
- **Mailing address:** 3415 W LAKE MARY BLVD UNIT 950460, LAKE MARY, FL 32795-7520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |

## Other

- **Enumeration date:** 09/29/2026
- **Last updated:** 09/29/2026