Provider Demographics
NPI:1417358243
Name:LIMA, SAMUEL (MA, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:LIMA
Suffix:
Gender:M
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-4227
Mailing Address - Country:US
Mailing Address - Phone:727-871-0327
Mailing Address - Fax:
Practice Address - Street 1:550 7TH ST S
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-4227
Practice Address - Country:US
Practice Address - Phone:727-871-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health