Provider Demographics
NPI:1316245640
Name:GOLONKA, LINDSEY (MA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GOLONKA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 3RD AVE N UNIT 406
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3378
Mailing Address - Country:US
Mailing Address - Phone:277-428-6977
Mailing Address - Fax:800-981-5129
Practice Address - Street 1:235 3RD AVE N UNIT 406
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3378
Practice Address - Country:US
Practice Address - Phone:727-742-8697
Practice Address - Fax:800-981-5129
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FL1-16-21429103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health