Active NPI
Lyndian Marta Chacon, MPS
- Professional Counselor
- Tampa, FL
National Provider Identifier
1366852253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 12512 Bruce B Downs Blvd
Tampa, FL 33612-9209 - Phone
- (813) 977-8700
- NPI assigned
- May 1, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
12512 Bruce B Downs Blvd
Tampa, FL 33612-9209
Mailing address
17823 Morninghigh Dr
Lutz, FL 33549-5525
Phone (813) 948-6075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398902400000",
"number": "1366852253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17823 MORNINGHIGH DR",
"city": "LUTZ",
"state": "FL",
"postal_code": "335495525",
"telephone_number": "813-948-6075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12512 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129209",
"telephone_number": "813-977-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACON",
"first_name": "LYNDIAN",
"middle_name": "MARTA",
"credential": "MPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-01",
"last_updated": "2014-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.