Organization
ORTIZ PROFESSIONAL SERVICES LLC
Active
Other names
Ortiz Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENIA N. DAVILA ORTIZ MHC, CADC (PRESIDENT)
(904) 523-1287
Entity
Organization
Contact information
Practice address
1857 WELLS RD STE 216, ORANGE PARK, FL 32073-2340
(904) 523-1287
(904) 615-6919
Mailing address
1857 WELLS RD STE 216, ORANGE PARK, FL 32073-2340
(904) 523-1287
(904) 615-6919
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/29/2023
Last updated
05/13/2025
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