MEDICARE: MICAH KOINYAN MASSAQUOI JR. 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	27328	FL

General Provider Information

NPI Number	:	1295663490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAH KOINYAN MASSAQUOI JR. LMHC

Provider Business Mailing Address
First Line	:	1964 HOWELL BRANCH RD STE 106
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-1042
Country	:	US
Telephone Number	:	407-459-4117
Fax Number	:

Provider Business Practice Location Address
First Line	:	1964 HOWELL BRANCH RD STE 106
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-1042
Country	:	US
Telephone Number	:	407-459-4117
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

Similar Medicare Providers

1982876918 — CRDENTIA CORPORATION
Practice Location Address:

1964 HOWELL BRANCH RD , SUITE 205
WINTER PARK, FL
32792-1042

Practice Phone: 407-677-0400
Practice Fax:

1013273887 — ELLEN MEGGINSON MA, LMHC
Practice Location Address:

1964 HOWELL BRANCH ROAD , SUITE 102
WINTER PARK, FL
32792-1042

Practice Phone: 407-279-1816
Practice Fax:

1255670337 — LESLIE K. HILL M.S.
Practice Location Address:

1964 HOWELL BRANCH RD STE 100
WINTER PARK, FL
32792-1042

Practice Phone: 352-875-3256
Practice Fax: 407-657-4269

1578011987 — LEGS LLC
Practice Location Address:

1964 HOWELL BRANCH RD , SUITE 100
WINTER PARK, FL
32792-1042

Practice Phone: 407-276-7326
Practice Fax: 407-264-8261

1609326503 — PINNACLE COUNSELING INSTITUTE, INC.
Practice Location Address:

1964 HOWELL BRANCH RD STE 106
WINTER PARK, FL
32792-1042

Practice Phone: 407-657-5800
Practice Fax: 407-657-4269

1073064622 — MRS. ANITA MARGARET JOBSON MA
Practice Location Address:

1964 HOWELL BRANCH RD , SUITE 106
WINTER PARK, FL
32792-1042

Practice Phone: 407-490-4303
Practice Fax:

Directions to “ MICAH KOINYAN MASSAQUOI JR. LMHC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.