=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215440805
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEBB COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2017
-----------------------------------------------------
Last Update Date | 04/03/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 343 W CENTRAL AVE STE 105-3
-----------------------------------------------------
City | LAKE WALES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33853-4059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-978-8092
-----------------------------------------------------
Fax | 863-546-6157
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 343 W CENTRAL AVE STE 105-3
-----------------------------------------------------
City | LAKE WALES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33853-4059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-978-8092
-----------------------------------------------------
Fax | 863-546-6157
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNSELOR
-----------------------------------------------------
Name | DR. ROSEMARY WEBB
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 863-978-8092
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | MH8196
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MH8196
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------