Provider Demographics
NPI:1285260083
Name:BOISBEL, MARIE CARMELLE (LMHC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CARMELLE
Last Name:BOISBEL
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 1:2189 BERKLEY WAY
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33973-6010
Mailing Address - Country:US
Mailing Address - Phone:239-738-0926
Mailing Address - Fax:
Practice Address - Street 1:10491 6 MILE CYPRESS PKWY STE 245
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-6532
Practice Address - Country:US
Practice Address - Phone:941-548-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17113101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health