Provider Demographics
NPI:1427687581
Name:STANCIL, LASHELIA ANN (RMFTI)
Entity type:Individual
Prefix:
First Name:LASHELIA
Middle Name:ANN
Last Name:STANCIL
Suffix:
Gender:F
Credentials:RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 S SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4824
Mailing Address - Country:US
Mailing Address - Phone:863-978-3444
Mailing Address - Fax:
Practice Address - Street 1:180 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-6308
Practice Address - Country:US
Practice Address - Phone:863-210-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist