MEDICARE: ALL TOO WELL THERAPY 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1871358903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL TOO WELL THERAPY LLC

Provider Business Mailing Address
First Line	:	2417 MINNESOTA AVE
Second Line	:
City	:	LYNN HAVEN
State	:	FL
Zip	:	32444-4812
Country	:	US
Telephone Number	:	850-209-2423
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 MINNESOTA AVE
Second Line	:
City	:	LYNN HAVEN
State	:	FL
Zip	:	32444-4812
Country	:	US
Telephone Number	:	850-209-2423
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MGR
Name	:	ELIZABETH LAWRENCE
Credential	:	LMHC
Telephone Number	:	850-209-2423

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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