Provider Demographics
NPI:1144066895
Name:WEGERIF, DENISE (LMHC, LMFT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WEGERIF
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8249 DEVEREUX DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7955
Mailing Address - Country:US
Mailing Address - Phone:321-259-1662
Mailing Address - Fax:321-779-7729
Practice Address - Street 1:8249 DEVEREUX DR STE 101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7955
Practice Address - Country:US
Practice Address - Phone:321-259-1662
Practice Address - Fax:321-779-7729
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4094106H00000X
FLMH19362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist