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General NPI Number Information
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NPI Number | 1164131561
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Entity Type | Individual
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Provider Name | KARLIE MATAYA LABARBARA LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 107 DR MARTIN LUTHER KING JR AVE STE 1
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City | INVERNESS
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State | FL
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Zip | 34450-4300
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Country | US
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Telephone | 813-666-2714
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Fax | 352-565-4131
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Provider Business Mailing Address
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Address Line | 150 MAGNOLIA AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4304
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Country | US
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Telephone | 386-236-3225
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Fax | 352-565-4131
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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 | MH21478
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License Number State | FL
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