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General NPI Number Information
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NPI Number | 1528256690
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Entity Type | Individual
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Provider Name | EDWARD LEE SOMERS LMHC, CEAP, NCC,NBCC
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Gender | Male
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Dates
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Enumeration Date | 10/14/2007
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 101 N WOODLAND BLVD SUITE 204
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City | DELAND
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State | FL
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Zip | 32720-4245
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Country | US
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Telephone | 321-277-7714
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Fax | 386-734-2475
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Provider Business Mailing Address
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Address Line | 101 N WOODLAND BLVD SUITE 204
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City | DELAND
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State | FL
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Zip | 32720-4245
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Country | US
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Telephone | 321-277-7714
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Fax | 386-734-2475
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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 | MH0001884
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License Number State | FL
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