LAKEWOOD RANCH COUNSELING NPI 1699332106

NPI Information

LAKEWOOD RANCH COUNSELING is a mental health counselor in Bradenton, FL. LAKEWOOD RANCH COUNSELING NPI is 1699332106. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8636 STATE ROAD 70 E
BRADENTON, FL
ZIP 34202-785
Phone: (941) 549-1521

The provider's authorized official is Travis Hage .
The authorized official title is Single Member Manager and has the following contact phone number (941) 549-1521.

The CLIA number assigned to this NPI record is 10D2041584 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2019 and was last updated on 5/21/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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