MEDICARE: MS. STEPHANIE NICHOLE LINCOLN LMHC

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	MH9174	FL

General Provider Information

NPI Number	:	1215123278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE NICHOLE LINCOLN LMHC

Provider Business Mailing Address
First Line	:	3704 POINT PLEASANT RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4267
Country	:	US
Telephone Number	:	904-599-8994
Fax Number	:

Provider Business Practice Location Address
First Line	:	3704 POINT PLEASANT RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4267
Country	:	US
Telephone Number	:	904-599-8994
Fax Number	:

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

Provider Enumeration Date	:	09/23/2007
Last Update Date	:	05/20/2022

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