=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609325976
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DENISE SCHONWALD, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2016
-----------------------------------------------------
Last Update Date | 09/28/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10441 QUALITY DR #205
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34609-9656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-666-4766
-----------------------------------------------------
Fax | 352-666-4366
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10441 QUALITY DR #205
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34609-9656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-666-4766
-----------------------------------------------------
Fax | 352-666-4366
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | DENISE SCHONWALD
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 352-666-4766
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MH14524
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------