Healthcare Provider Details

I. General information

NPI: 1720069784
Provider Name (Legal Business Name): LARRY ENGLISH LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 W LAKEVIEW AVE
PENSACOLA FL
32501-1857
US

IV. Provider business mailing address

1221 W LAKEVIEW AVE
PENSACOLA FL
32501-1857
US

V. Phone/Fax

Practice location:
  • Phone: 850-469-3500
  • Fax: 850-469-3424
Mailing address:
  • Phone: 850-469-3500
  • Fax: 850-469-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH6725
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: