Individual
DOUGLASS PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC, QS, LPC
Contact information
Practice address
1619 HANKS AVE, ORLANDO, FL 32814-6707
(678) 477-8747
Mailing address
1619 HANKS AVE, ORLANDO, FL 32814-6707
(678) 477-8747
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH17517
FL
101YP2500X
Professional Counselor
Primary
LPC005791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC005791
GA COMPOSITE BOARD
GA
01
—
MH17517
FL BOARD OF MHC
FL
Enumeration date
11/30/2006
Last updated
03/30/2020
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