MEDICARE: DONNA LYNN MUSSELWHITE

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	101YS0200X	School Counselor	799541	FL
2	101YM0800X	Mental Health Counselor	MH5350	FL
3	101YM0800X	Mental Health Counselor	5429	MN

General Provider Information

NPI Number	:	1598339475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA LYNN MUSSELWHITE

Provider Business Mailing Address
First Line	:	1565 VINELAND CIR UNIT B
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4208
Country	:	US
Telephone Number	:	904-537-9864
Fax Number	:

Provider Business Practice Location Address
First Line	:	1565 VINELAND CIR UNIT B
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4208
Country	:	US
Telephone Number	:	904-537-9864
Fax Number	:

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

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	02/18/2026

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Directions to “ DONNA LYNN MUSSELWHITE ” Practice Location

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