Healthcare Provider Details

I. General information

NPI: 1750640348
Provider Name (Legal Business Name): W. JIM STRIEGEL, LMHC COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 05/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

IV. Provider business mailing address

5465 COMMERCIAL WAY
SPRING HILL FL
34606-1110
US

V. Phone/Fax

Practice location:
  • Phone: 352-597-5497
  • Fax:
Mailing address:
  • Phone: 352-597-5497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberMH 9374
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberMH 9374
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberMH 9374
License Number StateFL

VIII. Authorized Official

Name: MR. WILLIAM JAMES STRIEGEL
Title or Position: MENTAL HEALTH COUNSELOR
Credential: L.M.H.C.
Phone: 352-597-5497