Healthcare Provider Details

I. General information

NPI: 1952765422
Provider Name (Legal Business Name): TAMI LYNN BYRD LCDC, LPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMI LYNN DORNER LCDC, LPC

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 METRO PKWY STE 205
FORT MYERS FL
33916-9416
US

IV. Provider business mailing address

4310 METRO PKWY STE 205
FORT MYERS FL
33916-9416
US

V. Phone/Fax

Practice location:
  • Phone: 239-690-6906
  • Fax:
Mailing address:
  • Phone: 239-690-6906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12812
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number73108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: