Provider Demographics
NPI:1497916241
Name:LYME, ALAN PHILIP (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:PHILIP
Last Name:LYME
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5126 SW BIMINI CIR S
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-1257
Mailing Address - Country:US
Mailing Address - Phone:772-781-5312
Mailing Address - Fax:
Practice Address - Street 1:5126 SW BIMINI CIR S
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-1257
Practice Address - Country:US
Practice Address - Phone:772-781-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 2663101YA0400X
FLSW71081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)