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NPI Code Detail

MEDICARE: CALLIE CLINCH LMHC, NCC

MEDICARE: CALLIE CLINCH LMHC, NCC
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 CounselorMH17949FL

General Provider Information

NPI Number : 1386266096
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLIE CLINCH LMHC, NCC
Provider Business Mailing Address
First Line : 201 N US HIGHWAY 1 STE D10
Second Line : #1107
City : JUPITER
State : FL
Zip : 33477-5135
Country : US
Telephone Number : 561-444-9788
Fax Number :
Provider Business Practice Location Address
First Line : 3801 PGA BLVD STE 656
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33410-2756
Country : US
Telephone Number : 561-444-9788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2020
Last Update Date : 01/22/2026

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