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NPI Code Detail

MEDICARE: LISA MICHELLE BRANHAM LMHC

MEDICARE: LISA MICHELLE BRANHAM 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
1101YM0800XMental Health CounselorMH10872FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619002409
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MICHELLE BRANHAM LMHC
Provider Business Mailing Address
First Line : 9995 GATE PKWY N STE 100
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-0800
Country : US
Telephone Number : 833-769-3524
Fax Number :
Provider Business Practice Location Address
First Line : 9995 GATE PKWY N STE 100
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-0800
Country : US
Telephone Number : 833-769-3524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 10/24/2025

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Directions to “ LISA MICHELLE BRANHAM LMHC” Practice Location

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