Provider Demographics
NPI:1447399324
Name:WINN, LISA BUNING (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:BUNING
Last Name:WINN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 NW 43RD ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6675
Mailing Address - Country:US
Mailing Address - Phone:352-378-0900
Mailing Address - Fax:
Practice Address - Street 1:2610 NW 43RD ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6675
Practice Address - Country:US
Practice Address - Phone:352-378-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH8000OtherFLORIDA STATE LICENSE