Provider Demographics
NPI:1972849248
Name:LINDO, NICKOLLE (LMHC, MCAP)
Entity Type:Individual
Prefix:
First Name:NICKOLLE
Middle Name:
Last Name:LINDO
Suffix:
Gender:F
Credentials:LMHC, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E BAKER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-3700
Mailing Address - Country:US
Mailing Address - Phone:813-541-2472
Mailing Address - Fax:
Practice Address - Street 1:1001 E BAKER ST STE 100
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-3700
Practice Address - Country:US
Practice Address - Phone:813-754-5555
Practice Address - Fax:813-754-5552
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH12387OtherSTATE OF FLORIDA, DEPARTMENT OF HEALTH, LMHC
FL50360OtherFLORIDA CERTIFICATION BOARD, CAP