Individual provider · Type 1 NPI

Charnelle Willis

Mental Health Counselor · Port St. Lucie, FL

NPI number 1104300623 Active

Practice location

525 NW Lake Whitney Pl
Port St. Lucie, FL 34986-1605

Call (772) 337-8164 Map

Mailing address

4977 NW Foxworth Ave
Port St. Lucie, FL 34983-2302

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104300623

Charnelle Willis's National Provider Identifier is 1104300623, issued on Sep 20, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Port St. Lucie, FL. The record was last updated on Sep 20, 2018.