Provider Demographics
NPI:1265744031
Name:PATEL, GITA M (LMHC)
Entity type:Individual
Prefix:MRS
First Name:GITA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 OTTER CREEK TRL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4117
Mailing Address - Country:US
Mailing Address - Phone:908-447-6405
Mailing Address - Fax:
Practice Address - Street 1:12005 OTTER CREEK TRL
Practice Address - Street 2:SUITE 1
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-4117
Practice Address - Country:US
Practice Address - Phone:908-447-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NJ37PC00397400101YP2500X
FLMH12575101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional