Healthcare Provider Details

I. General information

NPI: 1336791813
Provider Name (Legal Business Name): LORETTA ANN PLAYER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORETTA ANN BARANOWSKI

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 N CLYDE MORRIS BLVD STE 140
DAYTONA BEACH FL
32117-5534
US

IV. Provider business mailing address

1737 N CLYDE MORRIS BLVD STE 140
DAYTONA BEACH FL
32117-5534
US

V. Phone/Fax

Practice location:
  • Phone: 386-262-1627
  • Fax:
Mailing address:
  • Phone: 386-262-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH19686
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: