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NPI Code Detail

MEDICARE: MR. DANIEL J. RESH JR. LMHC

MEDICARE: MR. DANIEL J. RESH JR. LMHC
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
1101YP2500XProfessional CounselorMH5490FL
2101YM0800XMental Health CounselorMH5490FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063634384
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL J. RESH JR. LMHC
Provider Business Mailing Address
First Line : PO BOX 1284
Second Line :
City : CAPE CANAVERAL
State : FL
Zip : 32920-1284
Country : US
Telephone Number : 321-267-2228
Fax Number : 866-703-0035
Provider Business Practice Location Address
First Line : 6700 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-8050
Country : US
Telephone Number : 321-269-4590
Fax Number : 321-268-5689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 06/26/2022

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