Provider Demographics
NPI:1407136930
Name:STUBENBORT, LYNDSEY (MS)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:STUBENBORT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 PRITCHARD ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-3571
Mailing Address - Country:US
Mailing Address - Phone:352-537-9022
Mailing Address - Fax:
Practice Address - Street 1:1601 NE 25TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-8800
Practice Address - Country:US
Practice Address - Phone:352-671-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health