Provider Demographics
NPI:1518394618
Name:MIKE DEASE, LMHC, CAP, LLC
Entity Type:Organization
Organization Name:MIKE DEASE, LMHC, CAP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEASE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CAP
Authorized Official - Phone:850-577-1555
Mailing Address - Street 1:1106 THOMASVILLE RD STE F
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6587
Mailing Address - Country:US
Mailing Address - Phone:850-577-1555
Mailing Address - Fax:850-577-1556
Practice Address - Street 1:1106 THOMASVILLE RD STE F
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6587
Practice Address - Country:US
Practice Address - Phone:850-577-1555
Practice Address - Fax:850-577-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty