MEDICARE: MARK ODELL 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	MH15754	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1558849943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ODELL LMHC

Provider Business Mailing Address
First Line	:	6901A N 9TH AVE # 1363
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32504-6638
Country	:	US
Telephone Number	:	850-377-1354
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901A N 9TH AVE # 1363
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32504-6638
Country	:	US
Telephone Number	:	850-736-4345
Fax Number	:

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

Provider Enumeration Date	:	07/30/2018
Last Update Date	:	03/12/2025

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Directions to “ MARK ODELL LMHC” Practice Location

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