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NPI Code Detail

MEDICARE: PAULA SUMNER LMHC

MEDICARE: PAULA SUMNER LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH0001240FL

General Provider Information

NPI Number : 1366584138
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA SUMNER LMHC
Provider Business Mailing Address
First Line : 6700 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-8050
Country : US
Telephone Number : 321-269-4590
Fax Number :
Provider Business Practice Location Address
First Line : 6700 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-8050
Country : US
Telephone Number : 321-269-4590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 07/08/2007

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