Tabula Rasa Renewed

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

TABULA RASA RENEWED

Practice address

702 Park Lake St
Orlando, FL 32803-4024

Phone

(407) 272-3700

NPI assigned

Mar 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cordett D McCall, LMHC

Title

President

Phone

(407) 272-3700

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1215279534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 PARK LAKE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 PARK LAKE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034024",
            "telephone_number": "407-272-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABULA RASA RENEWED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-25",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "CORDETT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-272-3700",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sterling Tabon, MSPH
• Caitlyn Tabor, M.A. CCC-SLP
• Leigh Ann Tabor, ARNP
• Nicole Tabor
• Jessica Taborda
• John Joseph Tacconi, DO
• Donald Ross Taddeo, DDS
• Semeon Tadesse
• Olivia Tadros
• Joanna E Taepke, PA

• Counselor in Orlando, FL
• Providers in Orlando, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.