Withers, Malissa B

Withers, Malissa B is an individual health care provider with primary practice located at 1515 Michelin Ct , Lutz FL 33549-7533. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Withers, Malissa B can be contacted via phone (813) 949-8946.

Contact Information

Primary practice address
1515 Michelin Ct Lutz FL 33549-7533
Phone: (813) 949-8946
Fax: (813) 949-2926
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH8079 Florida
Behavioral Health & Social Service Providers / Social Worker 104100000X Florida

Profile Details

NPI number 1689735375
LBN Legal business name Withers, Malissa B
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jan 4th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689735375 NPPES
Florida MEDICAID 767385000

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