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Organization
LAKEWOOD RANCH COUNSELING
Active
Organization
LAKEWOOD RANCH COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS HAGE LMHC (SINGLE MEMBER MANAGER)
(941) 549-1521
Entity
Organization
Contact information
Practice address
8636 STATE ROAD 70 E, BRADENTON, FL 34202-3785
(941) 549-1521
Mailing address
21705 67TH AVE E, BRADENTON, FL 34211-7089
(941) 549-1521
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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