Provider Demographics
NPI:1699374579
Name:PHOEBE C. HOUGHTON LCSW LLC
Entity Type:Organization
Organization Name:PHOEBE C. HOUGHTON LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PHOEBE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:603-831-2420
Mailing Address - Street 1:4321 ORANGE RIVER LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5816
Mailing Address - Country:US
Mailing Address - Phone:603-831-2420
Mailing Address - Fax:
Practice Address - Street 1:808 ANCHOR RODE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2739
Practice Address - Country:US
Practice Address - Phone:603-831-2420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)