Organization
BEACHSIDE COUNSELING AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY LAUER LMHC (OWNER)
(321) 327-3793
Entity
Organization
Contact information
Practice address
122 4TH AVE, SUITE 200, INDIALANTIC, FL 32903-3112
(321) 327-3793
Mailing address
2105 S RIVER RD, MELBOURNE BEACH, FL 32951-2929
(321) 327-3793
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MH9141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336264902
NPPES
FL
Enumeration date
12/28/2015
Last updated
12/28/2015
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