Provider Demographics
NPI:1629589791
Name:STANFIELD, LUCIA BERNADETTE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:BERNADETTE
Last Name:STANFIELD
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 1:5419 NW WISK FERN CIR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4365
Mailing Address - Country:US
Mailing Address - Phone:772-404-1564
Mailing Address - Fax:
Practice Address - Street 1:5419 NW WISK FERN CIR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4365
Practice Address - Country:US
Practice Address - Phone:772-404-1564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health