Provider Demographics
NPI:1376161695
Name:VANMETER, NATHAN TYLER (LMHC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:TYLER
Last Name:VANMETER
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 1:103 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4237
Mailing Address - Country:US
Mailing Address - Phone:571-318-0093
Mailing Address - Fax:
Practice Address - Street 1:1120 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2608
Practice Address - Country:US
Practice Address - Phone:850-434-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health