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General NPI Number Information
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NPI Number | 1902305881
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Entity Type | Organization
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Legal Business Name | MENTAL WELLNESS COUNSELING LLC
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 1680 EL JOBEAN RD STE 4
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1204
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Country | US
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Telephone | 941-979-0121
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Fax |
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Provider Business Mailing Address
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Address Line | 1680 EL JOBEAN RD STE 4
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1204
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Country | US
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Telephone | 941-979-0121
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Fax |
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Authorized Official
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Title or Position | LMHC, NCC
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Name | MS. DARIA ERDMANN
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Credential | M.A.
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Telephone | 941-979-0121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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