Provider Demographics
NPI:1194883611
Name:O'CONNELL, LINDA KAY (AP, LMHC, LMT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:AP, LMHC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 PEONY CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-6208
Mailing Address - Country:US
Mailing Address - Phone:813-855-3665
Mailing Address - Fax:
Practice Address - Street 1:12001 PEONY CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-6208
Practice Address - Country:US
Practice Address - Phone:813-855-3665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4742101YM0800X
FLAP1970171100000X
FLMA23119225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist