1659431997 NPI number — DR. ROSEMARY T WEBB LMHC

Table of content: DR. ROSEMARY T WEBB LMHC (NPI 1659431997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659431997 NPI number — DR. ROSEMARY T WEBB LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEBB
Provider First Name:
ROSEMARY
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659431997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
311 W 3RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FROSTPROOF
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33843-2202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-449-0550
Provider Business Mailing Address Fax Number:
863-546-6157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
343 W CENTRAL AVE STE 105-3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE WALES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33853-4059
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-978-8092
Provider Business Practice Location Address Fax Number:
863-546-6157
Provider Enumeration Date:
12/09/2006

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:  8196 , 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)

  • Identifier: 202693418 . This is a "TAX #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".