MEDICARE: MR. SCOTT A WELCH 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
1	101YM0800X	Mental Health Counselor	10603	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10603	OTHER	FL	LICENSED MENTAL HEALTH COUNSELOR

General Provider Information

NPI Number	:	1457824872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT A WELCH LMHC

Provider Business Mailing Address
First Line	:	548 FERN LAKE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-5031
Country	:	US
Telephone Number	:	813-263-9552
Fax Number	:	407-985-1933

Provider Business Practice Location Address
First Line	:	13980 LYNMAR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-3123
Country	:	US
Telephone Number	:	813-263-9552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	01/08/2019

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