Organization
GAINESVILLE COMMUNITY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY GREEN LMFT (EXECUTIVE DIRECTOR)
(352) 448-9120
Entity
Organization
Contact information
Practice address
3850 NW 83RD ST STE 201, GAINESVILLE, FL 32606-5601
(352) 448-9120
Mailing address
3850 NW 83RD ST STE 201, GAINESVILLE, FL 32606-5601
(352) 448-9120
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT2733
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
06/13/2018
Last updated
05/21/2024
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