Provider Demographics
NPI:1730994369
Name:LESTER, ELVIS K SR (MA, LMHC, NCC, MAC)
Entity type:Individual
Prefix:MR
First Name:ELVIS
Middle Name:K
Last Name:LESTER
Suffix:SR
Gender:M
Credentials:MA, LMHC, NCC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4912 THONOTOSASSA RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-5930
Mailing Address - Country:US
Mailing Address - Phone:813-362-7879
Mailing Address - Fax:
Practice Address - Street 1:600 S MAGNOLIA AVE STE 160
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2746
Practice Address - Country:US
Practice Address - Phone:813-221-5466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2221101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health