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Organization

ADULT COUNSELING & PSYCHOTHERAPY OF LAKE COUNTY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN C. VANGELDER DR.AD, LMHC, CAP (OWNER/PRESIDENT)
(352) 742-5665
Entity
Organization

Contact information

Practice address
131 W MAIN ST, TAVARES, FL 32778-3809
(352) 742-5665
(352) 343-8801
Mailing address
131 W MAIN ST, TAVARES, FL 32778-3809
(352) 742-5665
(352) 343-8801

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MH9157
FL
101YM0800X
Mental Health Counselor
Primary
MH9157
FL
1041C0700X
Clinical Social Worker
SW10470
FL
106H00000X
Marriage & Family Therapist
MH9157
FL
106H00000X
Marriage & Family Therapist
SW10470
FL

Other

Enumeration date
03/01/2012
Last updated
03/01/2012
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