MEDICARE: VIRTUAL HORIZONS COUNSELING SERVICES, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1427512730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUAL HORIZONS COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	10755 SW WATERWAY LN
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34987-2162
Country	:	US
Telephone Number	:	954-658-1145
Fax Number	:	954-252-3720

Provider Business Practice Location Address
First Line	:	1860 SW FOUNTAINVIEW BLVD STE 100
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-4528
Country	:	US
Telephone Number	:	954-658-1145
Fax Number	:	954-252-3720

Authorized Official
Title or Position	:	MANAGER
Name	:	CELIA TATMAN
Credential	:	LCMHC
Telephone Number	:	954-658-1145

Provider Enumeration Date	:	01/31/2019
Last Update Date	:	05/15/2026

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