Healthcare Provider Details

I. General information

NPI: 1255723227
Provider Name (Legal Business Name): SHELLEY A DRISKELL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 KASS CIR
SPRING HILL FL
34606-4308
US

IV. Provider business mailing address

6401 RIVER LODGE LN
WEEKI WACHEE FL
34607-4021
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-3188
  • Fax: 352-686-9394
Mailing address:
  • Phone: 352-232-7983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13136
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: