Provider Demographics
NPI:1619234069
Name:LANSINGER, DAVID (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LANSINGER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2842 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-6675
Mailing Address - Country:US
Mailing Address - Phone:407-644-8326
Mailing Address - Fax:
Practice Address - Street 1:2842 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-6675
Practice Address - Country:US
Practice Address - Phone:407-644-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9221Medicaid