Provider Demographics
NPI:1356680011
Name:GARZARELLI, PHILIP D (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:D
Last Name:GARZARELLI
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3904
Mailing Address - Country:US
Mailing Address - Phone:863-294-7062
Mailing Address - Fax:561-294-7064
Practice Address - Street 1:5001 S FLORIDA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2776
Practice Address - Country:US
Practice Address - Phone:561-684-7300
Practice Address - Fax:561-684-7450
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12511101YM0800X
FLIMH10010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health