| Tim Green Lmhc Llc | |
|
9500 Corkscrew Palms Cir Ste 3 Estero FL 33928 | |
| (239) 321-0797 | |
| (239) 390-0241 |
| Full Name | Tim Green Lmhc Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 9500 Corkscrew Palms Cir Ste 3, Estero, Florida |
| Authorized Official Name and Position | Tim Green (OWNER) |
| Authorized Official Contact | 2393210797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Green Lmhc Llc 229 Ambury St Fort Myers FL 33913-7131 Ph: (239) 321-0797 | Tim Green Lmhc Llc 9500 Corkscrew Palms Cir Ste 3 Estero FL 33928 Ph: (239) 321-0797 |
| NPI Number | 1336679950 |
|---|---|
| Provider Enumeration Date | 06/15/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336679950 | NPI | - | NPPES |
| 1689780603 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH7986 (Florida) | Primary |
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