Provider Demographics
NPI:1457824872
Name:WELCH, SCOTT A (LMHC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:A
Last Name:WELCH
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 1:548 FERN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5031
Mailing Address - Country:US
Mailing Address - Phone:813-263-9552
Mailing Address - Fax:407-985-1933
Practice Address - Street 1:13980 LYNMAR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3123
Practice Address - Country:US
Practice Address - Phone:813-263-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10603OtherLICENSED MENTAL HEALTH COUNSELOR