Provider Demographics
NPI:1316130461
Name:LAMBO COOMES, JENNIFER FAWN (LMHC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:FAWN
Last Name:LAMBO COOMES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1672 W SPRING MEADOW LOOP
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-7690
Mailing Address - Country:US
Mailing Address - Phone:352-423-3127
Mailing Address - Fax:
Practice Address - Street 1:475 CENTRAL AVE # 300B
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3859
Practice Address - Country:US
Practice Address - Phone:727-626-2067
Practice Address - Fax:727-380-6287
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health