Provider Demographics
NPI:1487859781
Name:STILES, LINDA ROSE (LMHC, DPHIL, LRP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ROSE
Last Name:STILES
Suffix:
Gender:F
Credentials:LMHC, DPHIL, LRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14006 LAKE PRICE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-3501
Mailing Address - Country:US
Mailing Address - Phone:407-375-7776
Mailing Address - Fax:863-709-8118
Practice Address - Street 1:4404 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2169
Practice Address - Country:US
Practice Address - Phone:863-709-8110
Practice Address - Fax:863-709-8118
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health