MEDICARE: LIVE WELL NOW MENTAL HEALTH SERVICES, LLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1528755774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE WELL NOW MENTAL HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	6305 NAPLES BLVD # 1120
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2071
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4529 DALMAHOY COURT
Second Line	:	APT 103
City	:	FT. MYERS
State	:	FL
Zip	:	33916
Country	:	US
Telephone Number	:	941-275-2806
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	MR. BRIAN ALEXANDER
Credential	:	LMHC
Telephone Number	:	239-270-4022

Provider Enumeration Date	:	04/19/2023
Last Update Date	:	04/19/2023

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