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General NPI Number Information
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NPI Number | 1912401068
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Entity Type | Individual
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Provider Name | LISA MARIE LYNN LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 3425 SW 74TH AVE STE C2
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City | OCALA
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State | FL
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Zip | 34474-7214
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Country | US
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Telephone | 352-454-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 9 NEEDLES DR
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City | OCALA
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State | FL
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Zip | 34482-3506
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Country | US
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Telephone | 352-454-8950
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Fax | 352-873-0035
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH12252
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH12252
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License Number State | FL
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