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General NPI Number Information
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NPI Number | 1811905763
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Entity Type | Individual
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Provider Name | MEENAKSHI M MOHAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 1201 FIRST STREET SOUTH
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City | WINTER HAVEN
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State | FL
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Zip | 33881
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Country | US
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Telephone | 863-294-7062
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Fax | 863-291-6084
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Provider Business Mailing Address
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Address Line | 1201 1ST ST S
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3904
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Country | US
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Telephone | 863-294-7062
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW8191
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License Number State | FL
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