Healthcare Provider Details

I. General information

NPI: 1215440805
Provider Name (Legal Business Name): WEBB COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 W CENTRAL AVE STE 105-3
LAKE WALES FL
33853-4059
US

IV. Provider business mailing address

343 W CENTRAL AVE STE 105-3
LAKE WALES FL
33853-4059
US

V. Phone/Fax

Practice location:
  • Phone: 863-978-8092
  • Fax: 863-546-6157
Mailing address:
  • Phone: 863-978-8092
  • Fax: 863-546-6157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8196
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH8196
License Number StateFL

VIII. Authorized Official

Name: DR. ROSEMARY WEBB
Title or Position: COUNSELOR
Credential: LMHC
Phone: 863-978-8092