MEDICARE: MR. JOSELYN PETERS 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
1	101YM0800X	Mental Health Counselor	MH23805	FL

General Provider Information

NPI Number	:	1083181937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSELYN PETERS LMHC

Provider Business Mailing Address
First Line	:	4104 BELLASOL CIR APT 1314
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-7301
Country	:	US
Telephone Number	:	813-525-3939
Fax Number	:

Provider Business Practice Location Address
First Line	:	4104 BELLASOL CIR APT 1314
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-7301
Country	:	US
Telephone Number	:	813-525-3939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2018
Last Update Date	:	11/03/2025

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