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Organization
ORTIZ PROFESSIONAL SERVICES LLC
Active
Organization
ORTIZ PROFESSIONAL SERVICES LLC
Active
Other names
Ortiz Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENIA N. DAVILA ORTIZ MHC, CADC (PRESIDENT)
(904) 523-1287
Entity
Organization
Contact information
Practice address
1855 WELLS RD STE 1, ORANGE PARK, FL 32073-6766
(904) 523-1287
(904) 615-6919
Mailing address
1857 WELLS RD STE 216, ORANGE PARK, FL 32073-2340
(904) 523-1287
(904) 615-6919
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
11/29/2023
Last updated
07/28/2026
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