MEDICARE: JOANN BLUMENTHAL 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	MH6207	FL

General Provider Information

NPI Number	:	1922211374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN BLUMENTHAL LMHC

Provider Business Mailing Address
First Line	:	6930 HUNTINGTON LAKES CIR
Second Line	:	202
City	:	NAPLES
State	:	FL
Zip	:	34119-7983
Country	:	US
Telephone Number	:	239-949-2300
Fax Number	:	239-597-0724

Provider Business Practice Location Address
First Line	:	1415 PANTHER LN
Second Line	:	SUITE 352
City	:	NAPLES
State	:	FL
Zip	:	34109-7874
Country	:	US
Telephone Number	:	239-949-2300
Fax Number	:	239-597-0524

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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