Provider Demographics
NPI:1528341229
Name:WINN, VIRGINIA EVON (LMHC,CAP, ICADC)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:EVON
Last Name:WINN
Suffix:
Gender:F
Credentials:LMHC,CAP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 LAKE WORTH RD
Mailing Address - Street 2:SUITE 238
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2474
Mailing Address - Country:US
Mailing Address - Phone:561-713-1189
Mailing Address - Fax:561-713-1191
Practice Address - Street 1:8461 LAKE WORTH RD
Practice Address - Street 2:SUITE 238
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2474
Practice Address - Country:US
Practice Address - Phone:561-713-1189
Practice Address - Fax:561-713-1191
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 4445101YA0400X
FLMH9045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)