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General NPI Number Information
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NPI Number | 1922236066
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Entity Type | Individual
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Provider Name | LYNDA COOK GANNON LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2009
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 27604 CASHFORD CIR SUITE 102 A
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6952
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Country | US
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Telephone | 813-838-4807
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Fax |
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Provider Business Mailing Address
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Address Line | 10144 ARBOR RUN DR UNIT 13
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City | TAMPA
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State | FL
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Zip | 33647-3566
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Country | US
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Telephone | 305-308-5066
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 7123
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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 | SW7123
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License Number State | FL
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