Individual
VIVIAN MEHNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1835 GILMORE AVE, LAKELAND, FL 33805-3017
(863) 248-3300
(863) 534-7028
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 582-9251
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH6758
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
354703000
MAGELLAN
FL
05
—
760259600
—
FL
01
—
Z9741
BC/BS
FL
Enumeration date
09/30/2005
Last updated
08/20/2008
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