Provider Demographics
NPI:1356697874
Name:BERNAL, LILIAM (LCSW)
Entity type:Individual
Prefix:
First Name:LILIAM
Middle Name:
Last Name:BERNAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 W 73RD ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5551
Mailing Address - Country:US
Mailing Address - Phone:305-825-3872
Mailing Address - Fax:305-825-3873
Practice Address - Street 1:2163 W 73RD ST UNIT 4
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5551
Practice Address - Country:US
Practice Address - Phone:305-825-3872
Practice Address - Fax:305-825-3873
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW108151041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical