Provider Demographics
NPI:1164994687
Name:MOTAREFI, LYNDSEY (LMFT)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:MOTAREFI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 NE 72ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-5138
Mailing Address - Country:US
Mailing Address - Phone:860-575-5242
Mailing Address - Fax:
Practice Address - Street 1:4325 W SUNSET BLVD STE 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2180
Practice Address - Country:US
Practice Address - Phone:305-787-3677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-21
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3612106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist