1487879995 NPI number — MRS. ELISA ANN MOHN HORTON LMFT, LMHC, NCC

Table of content: MRS. ELISA ANN MOHN HORTON LMFT, LMHC, NCC (NPI 1487879995)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487879995 NPI number — MRS. ELISA ANN MOHN HORTON LMFT, LMHC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORTON
Provider First Name:
ELISA
Provider Middle Name:
ANN MOHN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT, LMHC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOHN
Provider Other First Name:
ELISA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED., ED.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487879995
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 SW MARTIN DOWNS BLVD
Provider Second Line Business Mailing Address:
STE. 317
Provider Business Mailing Address City Name:
PALM CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34990-2851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-426-9955
Provider Business Mailing Address Fax Number:
772-781-8388

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 SW MARTIN DOWNS BLVD
Provider Second Line Business Practice Location Address:
STE. 317
Provider Business Practice Location Address City Name:
PALM CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34990-2851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-426-9955
Provider Business Practice Location Address Fax Number:
772-781-8388
Provider Enumeration Date:
04/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH 8749 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: MT 2182 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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