| Michelle Asencio Lmhc-therapy Llc | |
|
3220 Park Branch Ave Clermont FL 34711-6235 | |
| (407) 717-1305 | |
| Not Available |
| Full Name | Michelle Asencio Lmhc-therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 3220 Park Branch Ave, Clermont, Florida |
| Authorized Official Name and Position | Michelle Asencio De Jesus (OWNER) |
| Authorized Official Contact | 4077171305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Asencio Lmhc-therapy Llc 3220 Park Branch Ave Clermont FL 34711-6235 Ph: () - | Michelle Asencio Lmhc-therapy Llc 3220 Park Branch Ave Clermont FL 34711-6235 Ph: (407) 717-1305 |
| NPI Number | 1669046033 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Certification Date | 05/13/2021 |
| Medicare PECOS PAC ID | 4981054293 |
|---|---|
| Medicare Enrollment ID | O20231229000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669046033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michelle Asencio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962635987 PECOS PAC ID: 5890145106 Enrollment ID: I20231229000068 |
| Provider Name | Kaiza C Canales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457469280 PECOS PAC ID: 4880691575 Enrollment ID: I20240113000454 |
| Provider Name | Breckin Crowley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154839280 PECOS PAC ID: 7810333473 Enrollment ID: I20240306002101 |
| Provider Name | David Gomez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922357227 PECOS PAC ID: 9133566524 Enrollment ID: I20240320004177 |
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