MEDICARE: LINDA KAY O'CONNELL A.P., LMHC, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH4742	FL
2	171100000X	Acupuncturist	AP1970	FL
3	225700000X	Massage Therapist	MA23119	FL

General Provider Information

NPI Number	:	1194883611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA KAY O'CONNELL A.P., LMHC, LMT

Provider Business Mailing Address
First Line	:	12001 PEONY CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33635-6208
Country	:	US
Telephone Number	:	813-855-3665
Fax Number	:

Provider Business Practice Location Address
First Line	:	12001 PEONY CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33635-6208
Country	:	US
Telephone Number	:	813-855-3665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	03/10/2017

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