Provider Demographics
NPI:1881866895
Name:LOUNSBURY, JAMES L (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:LOUNSBURY
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 1:171 BARONY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6117
Mailing Address - Country:US
Mailing Address - Phone:904-248-0005
Mailing Address - Fax:815-717-9837
Practice Address - Street 1:4741 ATLANTIC BLVD
Practice Address - Street 2:SUITE B-3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-1114
Practice Address - Country:US
Practice Address - Phone:904-248-0005
Practice Address - Fax:815-717-9837
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical