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NPI Code Detail

MEDICARE: MR. LENWORTH MCLEAN

MEDICARE: MR. LENWORTH MCLEAN
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1265872881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LENWORTH MCLEAN
Provider Business Mailing Address
First Line : 406 LAMKIN ST SW
Second Line :
City : PALM BAY
State : FL
Zip : 32908-4728
Country : US
Telephone Number : 321-327-4802
Fax Number : 321-327-4802
Provider Business Practice Location Address
First Line : 406 LAMKIN ST SW
Second Line :
City : PALM BAY
State : FL
Zip : 32908-4728
Country : US
Telephone Number : 321-327-4802
Fax Number : 321-327-4802
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2013
Last Update Date : 06/27/2013

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Directions to “ MR. LENWORTH MCLEAN ” Practice Location

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