Provider Demographics
NPI:1093484537
Name:LONDO, LEE (LMHC)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:
Last Name:LONDO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 ALHAMBRA ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-1045
Mailing Address - Country:US
Mailing Address - Phone:850-461-6377
Mailing Address - Fax:
Practice Address - Street 1:1804 LEWIS TURNER BLVD
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-3256
Practice Address - Country:US
Practice Address - Phone:850-499-0759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health