Healthcare Provider Details

I. General information

NPI: 1487332227
Provider Name (Legal Business Name): SARAH NICOLE MAGUIRE MUSIAL MS, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH NICOLE MAGUIRE

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 S FLORIDA AVE STE 105
LAKELAND FL
33803-3809
US

IV. Provider business mailing address

2600 S FLORIDA AVE STE 105
LAKELAND FL
33803-3809
US

V. Phone/Fax

Practice location:
  • Phone: 863-732-7200
  • Fax: 863-732-7201
Mailing address:
  • Phone: 863-732-7200
  • Fax: 863-732-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH21326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: