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General NPI Number Information
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NPI Number | 1003543273
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Entity Type | Individual
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Provider Name | CAROLINE PACE LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/06/2022
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Last Update Date | 08/06/2022
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Provider Practice Location Address
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Address Line | 111 ORANGE AVE # M-205
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City | FORT PIERCE
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State | FL
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Zip | 34950-4304
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Country | US
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Telephone | 772-207-1095
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Fax |
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Provider Business Mailing Address
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Address Line | 5637 NW COVENTRY CIR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-4056
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Country | US
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Telephone | 561-201-3302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH21010
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License Number State | FL
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