THE SOURCE OF AMERICALLC (NPI# 1942566393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942566393 |
| Entity Type | Organization |
| Organization Name | THE SOURCE OF AMERICALLC |
| Other Organization Name | THE SOURCE D.A.G. |
| Practice Address |
5301 Goddard Ave Orlando FL 32810-5437 |
| Practice Telephone | 4077156807 |
| Mailing Telephone | 4077156807 |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |
| Authorized Official Name | MR. RICK WHITE SR. (DIRECTOR) |
| Authorized Official Telephone | 9047034364 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAENISHA22 | 05 |
| Other Name | Type Code |
|---|---|
| the source d.a.g. | Doing Business As Name - Organization |
| Street Address |
5301 GODDARD AVE |
| City | ORLANDO |
| State | FL |
| Zip Code | 32810-5437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708344 | Courtney Anne Bass | Psychologist | 5736 Eggleston Avenue, Orlando, FL 32810 | 2020-10-19 |
| 1598273666 | Taylor Elizabeth Marshall | Behavior Technician | 3701 Maitland Summit Blvd, Orlando, FL 32810 | 2018-01-11 |
| 1962920595 | Sister With Destiny | Adult Companion | 5214 N. O. B. T Apt 103, Orlando, FL 32810 | 2017-09-04 |
| 1710408992 | Denise Lynn Mezquia | Optometrist | 1800 Pembrook Dr Ste 120, Orlando, FL 32810 | 2017-06-28 |
| 1407380603 | Naho Hattori | Student in an Organized Health Care Education/Training Program | 1800 Pembrook Dr Ste 200, Orlando, FL 32810 | 2017-04-13 |
| 1245774801 | Elite Physical Therapy & Health Care Services | Community/Behavioral Health | 5104 North Orange Blossom Trail, Suite 119, Orlando, FL 32810 | 2016-12-15 |
| 1841746518 | Marie Yveline Mauger | Licensed Practical Nurse | 4400 Park Eden Cir, Orlando, FL 32810 | 2016-08-31 |
| 1548619950 | Predestined 4 Purpose Inc | Home Health | 6826 Gadwall Lane, Orlando, FL 32810 | 2016-06-07 |
| 1881058998 | Xuong Vong | Massage Therapist | 9301 Summit Centre Way, Maitland, FL 32810 | 2016-04-06 |
| 1760862726 | Edwin Colon | Case Management | 2660 Environs Blvd, Orlando, FL 32810 | 2015-06-04 |
| Find all providers in zip 32810 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336753789 | Marite Martinez | Counselor | 2119 Lake Christie Dr, Orlando, FL 32809-7960 | 2020-09-02 |
| 1033758735 | Sylvia V. Ramos Perez | Counselor | 5000 Catspaw Ct, Orlando, FL 32808-5961 | 2019-12-27 |
| 1689212904 | Chad Brown | Counselor | 942 Coquina Rock St, Orlando, FL 32828-7099 | 2019-12-17 |
| 1396381455 | Latasha Quenshay Ursin | Counselor | 1277 N Semoran Blvd Ste 117, Orlando, FL 32807-3574 | 2019-11-25 |
| 1891346094 | Katrina Lynn Alfonso | Counselor | 4440 Medallion Dr Apt 817, Orlando, FL 32808-1165 | 2019-09-27 |
| 1962065748 | Alexandra Nicole Morales | Counselor | 7401 Kalani St, Orlando, FL 32822-5602 | 2019-04-17 |
| 1205397825 | Shannon Folsom | Counselor | 3741 Lasson Ct, Orlando, FL 32835-2669 | 2019-03-27 |
| 1043778244 | Tanya S Doyle | Counselor | 12890 S John Young Pkwy, Orlando, FL 32837-3400 | 2019-03-06 |
| 1437616521 | Brooke Parker | Counselor | 100 W. Columbia St., Orlando, FL 32806-1006 | 2019-02-25 |
| 1184107534 | Healing & Beyond Health Services | Counselor | 111 N Orange Ave Ste 829, Orlando, FL 32801-2316 | 2018-09-12 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.