Healthcare Provider Details

I. General information

NPI: 1558733311
Provider Name (Legal Business Name): LOGAN JONES SINCAVAGE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2832 SAGE CREEK RD
FORT COLLINS CO
80528-3105
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 561-309-4219
  • Fax:
Mailing address:
  • Phone: 561-309-4219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13456
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: