Individual provider · Type 1 NPI

Portia Eboni Carlisle, LMHC

Mental Health Counselor · Daytona Beach, FL

NPI number 1568055010 Active

Practice location

702 S Ridgewood Ave
Daytona Beach, FL 32114-5332

Mailing address

30B Louvet Ln
Palm Coast, FL 32137-9701

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1568055010

Portia Eboni Carlisle, LMHC's National Provider Identifier is 1568055010, issued on Feb 16, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Daytona Beach, FL. The record was last updated on Feb 16, 2021.