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General NPI Number Information
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NPI Number | 1780775361
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Entity Type | Individual
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Provider Name | BAMBI LYNN MACPHERSON LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 2206 SE 27TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33904-3328
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Country | US
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Telephone | 240-344-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 2206 SE 27TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33904-3328
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Country | US
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Telephone | 240-344-7383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10656
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW17289
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License Number State | FL
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