Healthcare Provider Details

I. General information

NPI: 1689475147
Provider Name (Legal Business Name): ELIZABETH MEJIA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N HIGHWAY 27 UNIT F
CLERMONT FL
34711-2431
US

IV. Provider business mailing address

405 LAZY HOLLOW DR
GROVELAND FL
34736-9585
US

V. Phone/Fax

Practice location:
  • Phone: 407-451-3863
  • Fax:
Mailing address:
  • Phone: 614-370-1254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH25356
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: