Provider Demographics
NPI:1265130934
Name:BAMBI LYNN MACPHERSON
Entity type:Organization
Organization Name:BAMBI LYNN MACPHERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BAMBI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MACPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-344-7383
Mailing Address - Street 1:2206 SE 27TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-3328
Mailing Address - Country:US
Mailing Address - Phone:240-344-7383
Mailing Address - Fax:239-294-3639
Practice Address - Street 1:2206 SE 27TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-3328
Practice Address - Country:US
Practice Address - Phone:240-344-7383
Practice Address - Fax:239-294-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health