Organization
PEACE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DOUGLAS LAPHAM LMHC (DIRECTOR)
(941) 467-2980
Entity
Organization
Contact information
Practice address
10461 6 MILE CYPRESS PKWY STE 504, FORT MYERS, FL 33966-6513
(941) 467-2980
Mailing address
10461 6 MILE CYPRESS PKWY STE 504, FORT MYERS, FL 33966-6513
(941) 467-2980
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116077800
—
FL
Enumeration date
01/07/2019
Last updated
09/11/2024
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