Provider Demographics
NPI:1336285634
Name:LUTHERAN SERVICES FLORIDA, INC.
Entity Type:Organization
Organization Name:LUTHERAN SERVICES FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:239-275-1126
Mailing Address - Street 1:3615 CENTRAL AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-8257
Mailing Address - Country:US
Mailing Address - Phone:239-278-1140
Mailing Address - Fax:239-275-8567
Practice Address - Street 1:3615 CENTRAL AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8257
Practice Address - Country:US
Practice Address - Phone:239-278-1140
Practice Address - Fax:239-275-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty