Provider Demographics
NPI:1144889411
Name:I AM HER COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:I AM HER COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-619-9597
Mailing Address - Street 1:5104 N ORANGE BLOSSOM TRL STE 121
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1013
Mailing Address - Country:US
Mailing Address - Phone:407-619-9597
Mailing Address - Fax:
Practice Address - Street 1:5104 N ORANGE BLOSSOM TRL STE 121
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1013
Practice Address - Country:US
Practice Address - Phone:407-619-9597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016708700Medicaid