Provider Demographics
NPI:1346360070
Name:WELLS, JOEL L (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:L
Last Name:WELLS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3077 GREEN TURTLE CIR
Mailing Address - Street 2:
Mailing Address - City:MIMS
Mailing Address - State:FL
Mailing Address - Zip Code:32754-6515
Mailing Address - Country:US
Mailing Address - Phone:321-267-8491
Mailing Address - Fax:
Practice Address - Street 1:690 FRIDAY RD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-3317
Practice Address - Country:US
Practice Address - Phone:321-636-9941
Practice Address - Fax:321-636-0915
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health