LYNN STEPHANIE JACKSON DORMAN (NPI# 1053959023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053959023 |
| Entity Type | Individual |
| Full Name | LYNN STEPHANIE JACKSON DORMAN |
| Credential | LMHC |
| Practice Address |
1700 Park St N Ste 110 St Petersburg FL 33710-4300 |
| Mailing Address |
2407 W Conley Ave Tampa FL 33611-4762 |
| Practice Telephone | 8136442747 |
| Mailing Telephone | 4042930395 |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH17541 | FL | Behavioral Health & Social Service Providers |
| Street Address |
1700 PARK ST N STE 110 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33710-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615812 | Bay Vision Inc | Optometrist | 6951 22nd Ave North, St. Petersburg, FL 33710 | 2020-10-05 |
| 1821566845 | Harish J. Patel, Md | Non-Pharmacy Dispensing Site | 6449 38th Avenue North, Suite B3, Saint Petersburg, FL 33710 | 2018-11-07 |
| 1659860708 | Lydia M Gomez | Physical Therapist | 6775 Crosswinds Dr. N, Saint Petersburg, FL 33710 | 2018-05-04 |
| 1619498169 | Tiffiny C Rudkin | Massage Therapist | 3039 - 49th St. N., St. Petersburg, FL 33710 | 2017-07-05 |
| 1114456480 | Roberto Macedo Dentistry LLC | Dentist | 7801 38th Ave North, St. Petersburg, FL 33710 | 2017-06-08 |
| 1528429495 | Frank Michael Massotto Jr. | Nurse Practitioner | 3251 66th St. North, St Petersburg, FL 33710 | 2016-03-18 |
| 1235522889 | Toby Weinman Assisted Living Residence | Assisted Living Facility | 240 59th St N, St Petersburg, FL 33710 | 2015-03-06 |
| 1821415951 | Ryan Troup | Physician Assistant | 603 - 7th St. S, Suite 360, Emergency Physicians of Saint Petersburg, Saint Petersburg, FL 33710 | 2014-03-26 |
| 1629491600 | Garett Janes Sears | Psychologist | 1913 Tyrone Blvd, St. Petersburg, FL 33710 | 2014-01-28 |
| 1912331943 | Solimar Jimenez Diaz | Obstetrics & Gynecology | 6450 38th Ave N Ste 200, St Petersburg, FL 33710 | 2013-08-27 |
| Find all providers in zip 33710 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770423 | Nickole Marguerite Wyse | Counselor | 7901 4th St N Ste 4000, St Petersburg, FL 33702-4305 | 2020-11-06 |
| 1598364747 | Sara Spiess | Counselor | 447 3rd Ave N Ste 204, St Petersburg, FL 33701-3245 | 2020-10-20 |
| 1669096400 | Bjorn Nagle | Counselor | 111 2nd Ave Ne Ste 1007, St Petersburg, FL 33701-3442 | 2020-06-06 |
| 1225658180 | Holly A Henderson | Counselor | 600 40th St N Apt 208, St Petersburg, FL 33713-6340 | 2020-04-21 |
| 1225657174 | Meaghan Campbell | Counselor | 749 Jasmine Way S, St Petersburg, FL 33705-4744 | 2020-04-10 |
| 1245865294 | Russia Ja'von Collins | Counselor | 833 22nd St S, St Petersburg, FL 33712-2250 | 2020-03-10 |
| 1063985091 | Carleah East | Counselor | 6675 38th Ave N Ste 102, St Petersburg, FL 33710-1534 | 2019-01-02 |
| 1992271167 | Devon Willette | Counselor | 3900 Queen St N, St Petersburg, FL 33714-4644 | 2018-10-16 |
| 1750862017 | Mind Body Wellness Group LLC | Counselor | 735 Arlington Ave N Ste 205, St Petersburg, FL 33701-3653 | 2018-08-24 |
| 1902308117 | Barbara Toczek | Counselor | 735 Arlington Ave N Ste 210, St Petersburg, FL 33701-3653 | 2018-03-03 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33710 |
Please comment or provide details below to improve the information on LYNN STEPHANIE JACKSON DORMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.