Provider Demographics
NPI:1831389410
Name:HUMPHREYS, NADIA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:NADIA
Middle Name:
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 W LAKE MARY BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3473
Mailing Address - Country:US
Mailing Address - Phone:407-761-2584
Mailing Address - Fax:407-322-8575
Practice Address - Street 1:3525 W LAKE MARY BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3473
Practice Address - Country:US
Practice Address - Phone:407-761-2584
Practice Address - Fax:407-322-8575
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health