Provider Demographics
NPI:1114188588
Name:LUCENA, WILLIAMS JOSE (MENTAL HEALTH COUNSE)
Entity Type:Individual
Prefix:
First Name:WILLIAMS
Middle Name:JOSE
Last Name:LUCENA
Suffix:
Gender:M
Credentials:MENTAL HEALTH COUNSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SE 15TH RD PH A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1201
Mailing Address - Country:US
Mailing Address - Phone:305-778-6795
Mailing Address - Fax:
Practice Address - Street 1:200 SE 15TH RD PH A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1201
Practice Address - Country:US
Practice Address - Phone:305-778-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health