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General NPI Number Information
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NPI Number | 1982025300
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Entity Type | Individual
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Provider Name | CARLISE CHERILYN MCLAUGHLIN LCSW, CAP
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Gender | Female
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Dates
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Enumeration Date | 01/02/2014
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 151 MARY ESTHER BLVD SUITE 310A
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City | MARY ESTHER
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State | FL
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Zip | 32569-1972
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Country | US
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Telephone | 850-226-6430
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Fax | 850-254-1986
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Provider Business Mailing Address
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Address Line | 151 MARY ESTHER BLVD SUITE 310A
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City | MARY ESTHER
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State | FL
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Zip | 32569-1972
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Country | US
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Telephone | 850-226-6430
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Fax | 850-254-1986
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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 | SW 11734
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License Number State | FL
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