Provider Demographics
NPI:1265800809
Name:ENGLE, ELENA MARIE (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:MARIE
Last Name:ENGLE
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MISS
Other - First Name:ELENA
Other - Middle Name:MARIE
Other - Last Name:ECKELBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1342 COLONIAL BLVD STE C21
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1004
Mailing Address - Country:US
Mailing Address - Phone:407-917-5205
Mailing Address - Fax:
Practice Address - Street 1:1342 COLONIAL BLVD STE C21
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1004
Practice Address - Country:US
Practice Address - Phone:407-917-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010233101YP2500X
MI6401015975101YP2500X
FLMH16647101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional