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General NPI Number Information
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NPI Number | 1114181500
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Entity Type | Organization
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Legal Business Name | HELENE SHUTE LLC
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 07/26/2013
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Provider Practice Location Address
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Address Line | 5237 SUMMERLIN COMMONS BLVD SUITE 218
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City | FORT MYERS
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State | FL
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Zip | 33907-2158
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Country | US
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Telephone | 239-849-2022
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Fax | 239-275-2203
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Provider Business Mailing Address
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Address Line | 12712 ASTON OAKS DR
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City | FORT MYERS
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State | FL
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Zip | 33912-1463
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Country | US
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Telephone | 239-848-2022
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Fax | 239-936-2690
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. HELENE BETH SHUTE
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Credential | LCSW
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Telephone | 239-848-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 6063
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License Number State | FL
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