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NPI Code Detail

MEDICARE: THOMAS B. UNSWORTH P.A.

MEDICARE: THOMAS B. UNSWORTH P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH4732FL

General Provider Information

NPI Number : 1033482955
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS B. UNSWORTH P.A.
Provider Business Mailing Address
First Line : 451 SW BETHANY DR
Second Line : SUITE 206
City : PORT ST LUCIE
State : FL
Zip : 34986-1964
Country : US
Telephone Number : 561-541-2005
Fax Number : 772-879-2077
Provider Business Practice Location Address
First Line : 6269 NW GISELA ST
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34986-3866
Country : US
Telephone Number : 561-541-2005
Fax Number : 772-879-2077
Authorized Official
Title or Position : PRESIDENT
Name : THOMAS BRANDON UNSWORTH
Credential : LMHC
Telephone Number : 561-541-2005
Provider Enumeration Date : 02/23/2012
Last Update Date : 02/23/2012

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Directions to “THOMAS B. UNSWORTH P.A. ” Practice Location

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