Healthcare Provider Details

I. General information

NPI: 1528574167
Provider Name (Legal Business Name): STEPHANIE REYES LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 S CONGRESS AVE
PALM SPRINGS FL
33406-7608
US

IV. Provider business mailing address

2330 S CONGRESS AVE
PALM SPRINGS FL
33406-7608
US

V. Phone/Fax

Practice location:
  • Phone: 561-432-5849
  • Fax:
Mailing address:
  • Phone: 561-432-5849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27647
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: