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General NPI Number Information
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NPI Number | 1588093413
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Entity Type | Individual
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Provider Name | MICHELLE PASTOR LMHC, CAP, ICADC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 30740 STATE ROAD 54 SUITE 128
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543
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Country | US
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Telephone | 813-484-0002
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Fax | 813-994-1770
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Provider Business Mailing Address
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Address Line | 27251 WESLEY CHAPEL BLVD STE 1246
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-4285
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Country | US
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Telephone | 813-484-0002
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Fax | 813-994-1770
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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 | 100
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License Number State | FL
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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 | 5033
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License Number State | FL
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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 | MH12879
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License Number State | FL
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