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General NPI Number Information
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NPI Number | 1568895712
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Entity Type | Individual
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Provider Name | LISA MARIE WESTCOAT LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 07/16/2023
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Provider Practice Location Address
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Address Line | 799 SE BROWNING AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3919
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Country | US
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Telephone | 772-259-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 799 SE BROWNING AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3919
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Country | US
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Telephone | 772-259-9868
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH10977
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19506
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License Number State | FL
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