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General NPI Number Information
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NPI Number | 1285421727
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Entity Type | Organization
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Legal Business Name | FAMLEE FIRST CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 10596 VERSAILLES BLVD
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City | WELLINGTON
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State | FL
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Zip | 33449-8083
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Country | US
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Telephone | 321-966-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 9314 FOREST HILL BLVD STE 842
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City | WELLINGTON
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State | FL
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Zip | 33411-6577
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Country | US
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Telephone | 321-966-9363
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT LEE
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Credential |
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Telephone | 321-966-9363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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