LYNN STEPHANIE JACKSON DORMAN


Address: 1700 Park St N Ste 110, St Petersburg, FL 33710-4300
Phone: 8136442747

LYNN STEPHANIE JACKSON DORMAN (NPI# 1053959023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053959023
Entity Type Individual
Full Name LYNN STEPHANIE JACKSON DORMAN
Credential LMHC
Practice Address 1700 Park St N Ste 110
St Petersburg
FL 33710-4300
Mailing Address 2407 W Conley Ave
Tampa
FL 33611-4762
Practice Telephone 8136442747
Mailing Telephone 4042930395
Enumeration Date 2019-12-20
Last Update Date 2019-12-20
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
MH17541 FL Behavioral Health & Social Service Providers

Office Location

Street Address 1700 PARK ST N STE 110
City ST PETERSBURG
State FL
Zip Code 33710-4300

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1659860708 Lydia M Gomez Physical Therapist 6775 Crosswinds Dr. N, Saint Petersburg, FL 33710 2018-05-04
1619498169 Tiffiny C Rudkin Massage Therapist 3039 - 49th St. N., St. Petersburg, FL 33710 2017-07-05
1114456480 Roberto Macedo Dentistry LLC Dentist 7801 38th Ave North, St. Petersburg, FL 33710 2017-06-08
1528429495 Frank Michael Massotto Jr. Nurse Practitioner 3251 66th St. North, St Petersburg, FL 33710 2016-03-18
1235522889 Toby Weinman Assisted Living Residence Assisted Living Facility 240 59th St N, St Petersburg, FL 33710 2015-03-06
1821415951 Ryan Troup Physician Assistant 603 - 7th St. S, Suite 360, Emergency Physicians of Saint Petersburg, Saint Petersburg, FL 33710 2014-03-26
1629491600 Garett Janes Sears Psychologist 1913 Tyrone Blvd, St. Petersburg, FL 33710 2014-01-28
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639770423 Nickole Marguerite Wyse Counselor 7901 4th St N Ste 4000, St Petersburg, FL 33702-4305 2020-11-06
1598364747 Sara Spiess Counselor 447 3rd Ave N Ste 204, St Petersburg, FL 33701-3245 2020-10-20
1669096400 Bjorn Nagle Counselor 111 2nd Ave Ne Ste 1007, St Petersburg, FL 33701-3442 2020-06-06
1225658180 Holly A Henderson Counselor 600 40th St N Apt 208, St Petersburg, FL 33713-6340 2020-04-21
1225657174 Meaghan Campbell Counselor 749 Jasmine Way S, St Petersburg, FL 33705-4744 2020-04-10
1245865294 Russia Ja'von Collins Counselor 833 22nd St S, St Petersburg, FL 33712-2250 2020-03-10
1063985091 Carleah East Counselor 6675 38th Ave N Ste 102, St Petersburg, FL 33710-1534 2019-01-02
1992271167 Devon Willette Counselor 3900 Queen St N, St Petersburg, FL 33714-4644 2018-10-16
1750862017 Mind Body Wellness Group LLC Counselor 735 Arlington Ave N Ste 205, St Petersburg, FL 33701-3653 2018-08-24
1902308117 Barbara Toczek Counselor 735 Arlington Ave N Ste 210, St Petersburg, FL 33701-3653 2018-03-03
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Competitor

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City ST PETERSBURG
Zip Code 33710

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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