Provider Demographics
NPI:1285778977
Name:WHEELER-ANTLE, CAROLE D (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:D
Last Name:WHEELER-ANTLE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 BEACH PKWY
Mailing Address - Street 2:211
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5487
Mailing Address - Country:US
Mailing Address - Phone:239-549-5783
Mailing Address - Fax:239-549-5783
Practice Address - Street 1:923 DEL PRADO BLVD STE 202
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3628
Practice Address - Country:US
Practice Address - Phone:239-772-5091
Practice Address - Fax:239-772-8921
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health