Provider Demographics
NPI:1578796538
Name:MESSINA, MIGUEL (LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:
Last Name:MESSINA
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S. BELCHER RD
Mailing Address - Street 2:SUITE B-4
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771
Mailing Address - Country:US
Mailing Address - Phone:727-434-2159
Mailing Address - Fax:727-531-0950
Practice Address - Street 1:1501 S. BELCHER RD
Practice Address - Street 2:SUITE B-4
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771
Practice Address - Country:US
Practice Address - Phone:727-434-2159
Practice Address - Fax:727-531-0950
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9393101Y00000X
FLCAP2881101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor