Healthcare Provider Details

I. General information

NPI: 1750766846
Provider Name (Legal Business Name): ANITA PETZOLD COCOVES LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANITA PETZOLD COCOVES PH.D., LMHC, MCAP

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

472 SE EDGEWOOD DR
STUART FL
34996-4712
US

IV. Provider business mailing address

472 SE EDGEWOOD DR
STUART FL
34996-4712
US

V. Phone/Fax

Practice location:
  • Phone: 772-215-9377
  • Fax:
Mailing address:
  • Phone: 772-215-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH3231
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH3231
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: