MEDICARE: MS. COURTNEY BEDFORD LPC, 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
1	101YP2500X	Professional Counselor	LPC005665	GA
2	101YM0800X	Mental Health Counselor	MH18805	FL

General Provider Information

NPI Number	:	1588707640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. COURTNEY BEDFORD LPC, LMHC

Provider Business Mailing Address
First Line	:	11710 SW 13TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-4812
Country	:	US
Telephone Number	:	678-643-2070
Fax Number	:

Provider Business Practice Location Address
First Line	:	11710 SW 13TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33025-4812
Country	:	US
Telephone Number	:	678-643-2070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	02/09/2021

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