Healthcare Provider Details

I. General information

NPI: 1710378328
Provider Name (Legal Business Name): LYNDI ESPIQUE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12397 S ORANGE BLOSSOM TRL # 102
ORLANDO FL
32837-6217
US

IV. Provider business mailing address

12397 S ORANGE BLOSSOM TRL # 102
ORLANDO FL
32837-6217
US

V. Phone/Fax

Practice location:
  • Phone: 321-586-3920
  • Fax:
Mailing address:
  • Phone: 321-586-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberISW9418
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW15305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: