Organization
CENTRAL FLORIDA PSYCHOTHERAPY SERVICES LLC
Active
Other names
Psychotherapy Services of Newlight
Organization subpart
No
Provider details
NPI number
Authorized official
JOMON THEKKETHOTTIYIL LCSW (OWNER)
(330) 416-3867
Entity
Organization
Contact information
Practice address
5302 S FLORIDA AVE STE 200, LAKELAND, FL 33813-4922
(853) 602-7001
(863) 583-8585
Mailing address
5302 S FLORIDA AVE STE 203, LAKELAND, FL 33813-4910
(863) 602-7001
(863) 583-8585
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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