Healthcare Provider Details

I. General information

NPI: 1558257790
Provider Name (Legal Business Name): LORYN JEAN PANAHPOUR LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9825 SW 63RD CT
PINECREST FL
33156-3330
US

IV. Provider business mailing address

9825 SW 63RD CT
PINECREST FL
33156-3330
US

V. Phone/Fax

Practice location:
  • Phone: 305-785-1443
  • Fax:
Mailing address:
  • Phone: 305-785-1443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0022496
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number25960
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: