Healthcare Provider Details

I. General information

NPI: 1255830287
Provider Name (Legal Business Name): SYLPHIA RENEE LINDSAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16365 SE 16TH PL
OCKLAWAHA FL
32179-2112
US

IV. Provider business mailing address

PO BOX 434
SILVER SPRINGS FL
34489-0434
US

V. Phone/Fax

Practice location:
  • Phone: 325-346-2376
  • Fax:
Mailing address:
  • Phone: 325-346-2376
  • Fax: 833-240-0432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14917
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: