Provider Demographics
NPI:1689005480
Name:POSTPARTUM ALLIANCE OF SOUTHWEST FLORIDA
Entity Type:Organization
Organization Name:POSTPARTUM ALLIANCE OF SOUTHWEST FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHOLICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-560-9885
Mailing Address - Street 1:23150 FASHION DR STE 232
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-2568
Mailing Address - Country:US
Mailing Address - Phone:239-560-9885
Mailing Address - Fax:
Practice Address - Street 1:23150 FASHION DR STE 232
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-2568
Practice Address - Country:US
Practice Address - Phone:239-560-9885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty