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General NPI Number Information
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NPI Number | 1700309945
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Entity Type | Individual
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Provider Name | JOEL MARK LAATSCH LMHC, NCC
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Gender | Male
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1119 NIKKI VIEW DRIVE
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-734-5672
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Fax | 813-248-5999
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Provider Business Mailing Address
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Address Line | 1119 NIKKI VIEW DR
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City | BRANDON
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State | FL
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Zip | 33511-4879
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Country | US
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Telephone | 813-734-5672
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Fax | 813-248-5999
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 13522
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License Number State | FL
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