MEDICARE: ELIZABETH LAWTON, LMHC, LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1114582244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH LAWTON, LMHC, LLC

Provider Business Mailing Address
First Line	:	420 S STATE ROAD 7 STE 118
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4304
Country	:	US
Telephone Number	:	904-452-4612
Fax Number	:	844-335-7127

Provider Business Practice Location Address
First Line	:	420 S STATE ROAD 7 STE 118
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4304
Country	:	US
Telephone Number	:	904-452-4612
Fax Number	:	844-335-7127

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH LAWTON
Credential	:	LMHC
Telephone Number	:	904-452-4612

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	05/03/2019

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