Provider Demographics
NPI:1639677297
Name:FABER, LINDSAY J (LMHC, QS, MS)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:J
Last Name:FABER
Suffix:
Gender:F
Credentials:LMHC, QS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E PISA PL
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-2585
Mailing Address - Country:US
Mailing Address - Phone:904-826-6949
Mailing Address - Fax:
Practice Address - Street 1:1750 A1A S STE A
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-5582
Practice Address - Country:US
Practice Address - Phone:904-990-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18391101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health