MEDICARE: JANET R WELLES 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	101Y00000X	Counselor	MH5921	FL
2	101YM0800X	Mental Health Counselor	MH5921	FL

General Provider Information

NPI Number	:	1841401098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET R WELLES LMHC

Provider Business Mailing Address
First Line	:	11776 W SAMPLE RD
Second Line	:	SUITE 104
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-3180
Country	:	US
Telephone Number	:	954-753-0467
Fax Number	:

Provider Business Practice Location Address
First Line	:	11776 W SAMPLE RD
Second Line	:	SUITE 104
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-3180
Country	:	US
Telephone Number	:	954-753-0467
Fax Number	:

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

Provider Enumeration Date	:	05/26/2007
Last Update Date	:	09/11/2025

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