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General NPI Number Information
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NPI Number | 1316628886
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Entity Type | Organization
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Legal Business Name | FLOWING WISDOM MENTAL HEALTH COUNSELING GROUP LLC
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 4803 SEABERG RD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-2862
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Country | US
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Telephone | 954-649-6592
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Fax |
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Provider Business Mailing Address
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Address Line | 18448 CORTES CREEK BLVD
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City | SPRING HILL
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State | FL
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Zip | 34610-0120
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Country | US
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Telephone | 815-278-8996
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COURTNEY CAVALL
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Credential | LMHC
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Telephone | 954-649-6592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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