South Lake Family Counseling Services

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

SOUTH LAKE FAMILY COUNSELING SERVICES

Practice address

12946 Colonnade Cir
Clermont, FL 34711-6611

Phone

(352) 359-2073

NPI assigned

Aug 17, 2020

Last updated

Aug 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Adrian T Manley, PHD, LMFT

Title

Owner/Therapist

Phone

(352) 359-2073

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1568073195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12946 COLONNADE CIR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116611",
            "telephone_number": "352-359-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12946 COLONNADE CIR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116611",
            "telephone_number": "352-359-2073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 N Frontage Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "34711",
            "country_code": "US",
            "telephone_number": "407-502-3387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH LAKE FAMILY COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "MANLEY",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "352-359-2073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Clermont, FL
• Providers in Clermont, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.