Provider Demographics
NPI:1669865267
Name:LEMONS, SELENA CHANEL BOWDEN (LMHC, NCC, CAP)
Entity Type:Individual
Prefix:MRS
First Name:SELENA
Middle Name:CHANEL BOWDEN
Last Name:LEMONS
Suffix:
Gender:F
Credentials:LMHC, NCC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11514 BUTTON BAY PL
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3021
Mailing Address - Country:US
Mailing Address - Phone:813-695-4543
Mailing Address - Fax:
Practice Address - Street 1:11514 BUTTON BAY PL
Practice Address - Street 2:
Practice Address - City:GIBSONTON
Practice Address - State:FL
Practice Address - Zip Code:33534-3021
Practice Address - Country:US
Practice Address - Phone:813-695-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 6009101YA0400X
FLMH 12995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)