Provider Demographics
NPI:1427247683
Name:HUME, ELTON (LMHC)
Entity type:Individual
Prefix:MR
First Name:ELTON
Middle Name:
Last Name:HUME
Suffix:
Gender:M
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:PO BOX 490226
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-0226
Mailing Address - Country:US
Mailing Address - Phone:352-315-0359
Mailing Address - Fax:
Practice Address - Street 1:5826 HOFFNER AVE
Practice Address - Street 2:SUITE 1001
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4806
Practice Address - Country:US
Practice Address - Phone:352-315-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3325101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6461OtherBC/BS
FLZ6142OtherBC/BS