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Organization
IVY BRIDGE COUNSELING, INC.
Active
Organization
IVY BRIDGE COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENATA HUEWITT LPC (OWNER, MENTAL HEALTH THERAPIST)
(912) 572-1602
Entity
Organization
Contact information
Practice address
587 E SR 434 UNIT 1021B, LONGWOOD, FL 32750-5284
(407) 565-7942
(540) 566-5036
Mailing address
2272 WEKIVA VILLAGE LN, APOPKA, FL 32703-2511
(912) 572-1602
(540) 566-5036
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017481030001
—
VA
Enumeration date
08/15/2022
Last updated
01/31/2024
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