Healthcare Provider Details

I. General information

NPI: 1609784891
Provider Name (Legal Business Name): STEPHANIE LEE SINGH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 STOCKTON ST
JACKSONVILLE FL
32204-2534
US

IV. Provider business mailing address

555 STOCKTON ST
JACKSONVILLE FL
32204-2534
US

V. Phone/Fax

Practice location:
  • Phone: 470-964-1086
  • Fax:
Mailing address:
  • Phone: 470-964-1086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH15698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: