Provider Demographics
NPI:1750488045
Name:FIELD, DAVID L (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:FIELD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4633 HICKORY OAK DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-6490
Mailing Address - Country:US
Mailing Address - Phone:727-480-7291
Mailing Address - Fax:352-592-7742
Practice Address - Street 1:12128 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-5575
Practice Address - Country:US
Practice Address - Phone:352-592-7740
Practice Address - Fax:352-592-7742
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist