Provider Demographics
NPI:1356833925
Name:WEBSTER, NATHANIEL (LMHC)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:WEBSTER
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 1:531 VERSAILLES DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4591
Mailing Address - Country:US
Mailing Address - Phone:747-263-2789
Mailing Address - Fax:
Practice Address - Street 1:531 VERSAILLES DR STE 100
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4591
Practice Address - Country:US
Practice Address - Phone:747-263-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health