Provider Demographics
NPI:1891887741
Name:LUMPKIN, EARL LESTER (MCAP, ICADC)
Entity Type:Individual
Prefix:MR
First Name:EARL
Middle Name:LESTER
Last Name:LUMPKIN
Suffix:
Gender:M
Credentials:MCAP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11031 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7182
Mailing Address - Country:US
Mailing Address - Phone:305-398-6100
Mailing Address - Fax:305-757-4465
Practice Address - Street 1:8895 N MILITARY TRL STE 101
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6220
Practice Address - Country:US
Practice Address - Phone:561-819-6999
Practice Address - Fax:561-469-2034
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL803321101YA0400X
FLADC-002751-2014101YA0400X
FLCBHT3258101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor