Provider Demographics
NPI:1467593483
Name:MESSMORE, CAROL (LMFT)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:MESSMORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-4107
Mailing Address - Country:US
Mailing Address - Phone:561-843-1058
Mailing Address - Fax:561-243-1828
Practice Address - Street 1:75 NE 6TH AVE
Practice Address - Street 2:SUITE 218-B
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5435
Practice Address - Country:US
Practice Address - Phone:561-843-1058
Practice Address - Fax:561-243-1828
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1860106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist