Provider Demographics
NPI:1174816060
Name:MCCUMBER, FREDERICK JOSHUA (EDS, LMFT, LMHC, NCC)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:JOSHUA
Last Name:MCCUMBER
Suffix:
Gender:M
Credentials:EDS, LMFT, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 W NEWBERRY RD STE F
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2368
Mailing Address - Country:US
Mailing Address - Phone:352-373-1218
Mailing Address - Fax:352-373-2191
Practice Address - Street 1:4010 W NEWBERRY RD STE F
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2368
Practice Address - Country:US
Practice Address - Phone:352-373-1218
Practice Address - Fax:352-373-2191
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10426101YM0800X
FLMT2523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health