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NPI Code Detail

MEDICARE: DEBORAH A CLEMENTS LMHC PA

MEDICARE: DEBORAH A CLEMENTS LMHC PA
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
1251S00000XCommunity/Behavioral Health AgencyMH10350FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811373780
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEBORAH A CLEMENTS LMHC PA
Provider Business Mailing Address
First Line : PO BOX 76423
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33734-6423
Country : US
Telephone Number : 813-625-6055
Fax Number : 727-823-8082
Provider Business Practice Location Address
First Line : 275 4TH ST N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33701-3205
Country : US
Telephone Number : 813-625-6055
Fax Number : 727-823-8082
Authorized Official
Title or Position : OWNER
Name : MS. DEBORAH A CLEMENTS
Credential : LMHC
Telephone Number : 813-625-6055
Provider Enumeration Date : 08/03/2015
Last Update Date : 08/03/2015

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