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NPI Code Detail

MEDICARE: MR. JOEL L WELLS LMHC

MEDICARE: MR. JOEL L WELLS 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
1101YM0800XMental Health CounselorMH8409FL

Other Identifiers

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

General Provider Information

NPI Number : 1346360070
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOEL L WELLS LMHC
Provider Business Mailing Address
First Line : 3077 GREEN TURTLE CIR
Second Line :
City : MIMS
State : FL
Zip : 32754-6515
Country : US
Telephone Number : 321-267-8491
Fax Number :
Provider Business Practice Location Address
First Line : 690 FRIDAY RD
Second Line :
City : COCOA
State : FL
Zip : 32926-3317
Country : US
Telephone Number : 321-636-9941
Fax Number : 321-636-0915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 07/08/2007

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