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General NPI Number Information
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NPI Number | 1952779753
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Entity Type | Organization
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Legal Business Name | CLINICAL PSYCHOTHERAPY AND COACHING SERVICES LLC
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 607 HIGHWAY 466 STE C
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City | LADY LAKE
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State | FL
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Zip | 32159-6339
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Country | US
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Telephone | 352-450-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 1286 EAGLE RIDGE DR
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City | THE VILLAGES
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State | FL
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Zip | 32162-7735
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Country | US
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Telephone | 352-450-7535
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA WESTRICH
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Credential | L.C.S.W.
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Telephone | 352-450-4535
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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 |
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License Number State |
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