Healthcare Provider Details
I. General information
NPI: 1568326999
Provider Name (Legal Business Name): JACQUIE LAMB, LMHC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2653 SW 87TH DR STE A
GAINESVILLE FL
32608-9382
US
IV. Provider business mailing address
2653 SW 87TH DR STE A
GAINESVILLE FL
32608-9382
US
V. Phone/Fax
- Phone: 352-331-0020
- Fax: 352-331-0022
- Phone: 352-331-0020
- Fax: 352-331-0022
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JACQUIE
LAMB
Title or Position: OWNER
Credential: LMHC
Phone: 352-332-0020