Provider Demographics
NPI:1487791604
Name:MESSENGER, CHARLENE M (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:M
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 E LIVINGSTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5401
Mailing Address - Country:US
Mailing Address - Phone:407-895-0540
Mailing Address - Fax:407-228-9771
Practice Address - Street 1:1237 E LIVINGSTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5401
Practice Address - Country:US
Practice Address - Phone:407-895-0540
Practice Address - Fax:407-228-9771
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH02676101YM0800X
FLSS00305103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist