Organization
STACY CARMICHAEL PHD LLC
Active
Parent organization
STACY CARMICHAEL PHD LLC
Other names
MindWorks Psychological Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
STACY CARMICHAEL PHD LLC
Authorized official
DR. STACY LYNN CARMICHAEL PHD (OWNER)
(407) 415-1450
Entity
Organization
Contact information
Practice address
310 S DILLARD ST STE 160, WINTER GARDEN, FL 34787-3500
(407) 415-1450
(321) 234-5587
Mailing address
663 E PLANT ST, WINTER GARDEN, FL 34787-3144
(727) 481-2444
(321) 234-5587
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063771376
GABY ZERPA LMHC NPI
—
01
—
1275667750
NPI
—
01
—
1679122048
DR. VISTA NPI
—
Enumeration date
05/18/2021
Last updated
05/18/2021
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