Provider Demographics
NPI:1437939642
Name:MAYFIELD, ELEANOR (LMHC)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 BIRKDALE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-2050
Mailing Address - Country:US
Mailing Address - Phone:334-796-9386
Mailing Address - Fax:
Practice Address - Street 1:1400 DUNLAWTON AVE STE 5E
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-8952
Practice Address - Country:US
Practice Address - Phone:386-361-8475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health