Provider Demographics
NPI:1215123278
Name:LINCOLN, STEPHANIE NICHOLE (LMHC)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:NICHOLE
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 POINT PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4267
Mailing Address - Country:US
Mailing Address - Phone:904-599-8994
Mailing Address - Fax:
Practice Address - Street 1:3704 POINT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4267
Practice Address - Country:US
Practice Address - Phone:904-599-8994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health