Provider Demographics
NPI:1659873313
Name:SOMERVILLE, EILEEN GIOVANNA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:GIOVANNA
Last Name:SOMERVILLE
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 1:2960 N STATE ROAD 7 STE 102
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5756
Mailing Address - Country:US
Mailing Address - Phone:954-361-1181
Mailing Address - Fax:
Practice Address - Street 1:2960 N STATE ROAD 7 STE 102
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5756
Practice Address - Country:US
Practice Address - Phone:954-361-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health