Provider Demographics
NPI:1932403599
Name:ELISA HORTON, LMFT, LMHC, NCC, INC
Entity Type:Organization
Organization Name:ELISA HORTON, LMFT, LMHC, NCC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LMHC, NCC
Authorized Official - Phone:772-426-9955
Mailing Address - Street 1:901 SW MARTIN DOWNS BLVD
Mailing Address - Street 2:STE. 317
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2862
Mailing Address - Country:US
Mailing Address - Phone:772-426-9955
Mailing Address - Fax:772-781-8388
Practice Address - Street 1:901 SW MARTIN DOWNS BLVD
Practice Address - Street 2:STE. 317
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2862
Practice Address - Country:US
Practice Address - Phone:772-426-9955
Practice Address - Fax:772-781-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8749101YM0800X
FLMT2182106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty