Healthcare Provider Details

I. General information

NPI: 1144139254
Provider Name (Legal Business Name): CAROLINA PASAHOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3765 COUNTY ROAD 513
WILDWOOD FL
34785-8342
US

IV. Provider business mailing address

3765 COUNTY ROAD 513
WILDWOOD FL
34785-8342
US

V. Phone/Fax

Practice location:
  • Phone: 561-531-1562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29094
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: