| Lakewood Ranch Counseling, Llc. | |
|
13571 Luxe Ave Apt 207 Bradenton FL 34211-4509 | |
| (941) 549-1521 | |
| Not Available |
| Full Name | Lakewood Ranch Counseling, Llc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 13571 Luxe Ave Apt 207, Bradenton, Florida |
| Authorized Official Name and Position | Travis Hage (SINGLE MEMBER MANAGER) |
| Authorized Official Contact | 9415491521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Ranch Counseling, Llc. 13571 Luxe Ave Apt 207 Bradenton FL 34211-4509 Ph: (941) 549-1521 | Lakewood Ranch Counseling, Llc. 13571 Luxe Ave Apt 207 Bradenton FL 34211-4509 Ph: (941) 549-1521 |
| NPI Number | 1275011231 |
|---|---|
| Provider Enumeration Date | 08/01/2018 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275011231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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