Provider Demographics
NPI:1215458260
Name:LLOYD, STACY LYNN (MS, LMHC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14651 SW 94TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1050
Mailing Address - Country:US
Mailing Address - Phone:305-301-3781
Mailing Address - Fax:
Practice Address - Street 1:1990 N FEDERAL HWY STE A
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1032
Practice Address - Country:US
Practice Address - Phone:954-532-9201
Practice Address - Fax:954-366-1430
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health