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General NPI Number Information
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NPI Number | 1073397196
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Entity Type | Organization
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Legal Business Name | FELLOW TRAVELER COUNSELING, LLC
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 9400 RIVER CROSSING BLVD STE 101
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-6033
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Country | US
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Telephone | 727-203-6713
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Fax |
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Provider Business Mailing Address
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Address Line | 12120 MAC DR
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City | HUDSON
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State | FL
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Zip | 34669-3771
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Country | US
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Telephone | 727-203-6713
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | DENNIS P BROWN
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Credential | LCSW
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Telephone | 727-203-6713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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