Provider Demographics
NPI:1407269665
Name:LUNDAY, MINDI (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:MINDI
Middle Name:
Last Name:LUNDAY
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 CAPTAINS CIR
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-5304
Mailing Address - Country:US
Mailing Address - Phone:214-542-0601
Mailing Address - Fax:
Practice Address - Street 1:428 CAPTAINS CIR
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5304
Practice Address - Country:US
Practice Address - Phone:214-542-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 12592101YM0800X
TX65266101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional