Healthcare Provider Details

I. General information

NPI: 1316804859
Provider Name (Legal Business Name): CASSANDRA LORENZ OBORNE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 PASEO REYES DR
ST AUGUSTINE FL
32095-8464
US

IV. Provider business mailing address

1910 N LOOP PKWY
ST AUGUSTINE FL
32095-4826
US

V. Phone/Fax

Practice location:
  • Phone: 904-829-2273
  • Fax: 904-824-0724
Mailing address:
  • Phone: 904-829-2273
  • Fax: 904-824-0724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27073
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: