Provider Demographics
NPI:1093145492
Name:HOWARD, VACHAREE (MSW)
Entity Type:Individual
Prefix:
First Name:VACHAREE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7275 CONCOURSE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-2895
Mailing Address - Country:US
Mailing Address - Phone:239-337-9024
Mailing Address - Fax:239-214-9786
Practice Address - Street 1:7275 CONCOURSE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2895
Practice Address - Country:US
Practice Address - Phone:239-337-9024
Practice Address - Fax:239-214-9786
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL65-0122844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65-0122844OtherEIN 65-0122844