Provider Demographics
NPI:1861803355
Name:RIVERA-LAKHAN, LILLIAN (LMHC)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:
Last Name:RIVERA-LAKHAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 VAN HERCKE LN
Mailing Address - Street 2:
Mailing Address - City:CHULUOTA
Mailing Address - State:FL
Mailing Address - Zip Code:32766-8814
Mailing Address - Country:US
Mailing Address - Phone:407-647-1781
Mailing Address - Fax:407-647-4628
Practice Address - Street 1:10967 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 113
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4457
Practice Address - Country:US
Practice Address - Phone:407-647-1781
Practice Address - Fax:407-647-4628
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4640101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor