Provider Demographics
NPI:1497866677
Name:EATON, EDWARD MITCHELL (LMHC)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:MITCHELL
Last Name:EATON
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:PO BOX 622199
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32762-2199
Mailing Address - Country:US
Mailing Address - Phone:407-605-2030
Mailing Address - Fax:888-589-7347
Practice Address - Street 1:15 WINDSORMERE WAY STE 300
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6507
Practice Address - Country:US
Practice Address - Phone:407-605-2030
Practice Address - Fax:888-589-7347
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health