MEDICARE: LINDSEY GOLONKA MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	103K00000X	Behavior Analyst	1-16-21429	FL

General Provider Information

NPI Number	:	1316245640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY GOLONKA MA

Provider Business Mailing Address
First Line	:	235 3RD AVE N UNIT 406
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3378
Country	:	US
Telephone Number	:	277-428-6977
Fax Number	:	800-981-5129

Provider Business Practice Location Address
First Line	:	235 3RD AVE N UNIT 406
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3378
Country	:	US
Telephone Number	:	727-742-8697
Fax Number	:	800-981-5129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	06/14/2021

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