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Organization
UPPER ROOM COUNSELING CENTER, INC.
Active
Organization
UPPER ROOM COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY FRANKLIN PHILLIPS L.M.H.C. (DIRECTOR OF COUNSELING)
(352) 435-4631
Entity
Organization
Contact information
Practice address
3420 HWY 27/441, FRUITLAND PARK, FL 34731-4474
(352) 435-4631
(352) 435-4632
Mailing address
3420 HWY 441/27, FRUITLAND PARK, FL 34731-4474
(352) 435-4631
(352) 435-4632
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MH-4358
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
MH-4358
FL
101YM0800X
Mental Health Counselor
Primary
MH-4358
FL
101YP1600X
Pastoral Counselor
MH-4358
FL
101YP2500X
Professional Counselor
MH-4358
FL
102L00000X
Psychoanalyst
MH-4358
FL
106H00000X
Marriage & Family Therapist
MH-4358
FL
Other
Enumeration date
10/07/2010
Last updated
07/31/2012
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