Provider Demographics
NPI:1174183537
Name:CALDERIN, LIANA (LMHC)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:CALDERIN
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 1:3501 DEL PRADO BLVD S STE 303
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7222
Mailing Address - Country:US
Mailing Address - Phone:239-317-0265
Mailing Address - Fax:239-673-7681
Practice Address - Street 1:3501 DEL PRADO BLVD S STE 303
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7222
Practice Address - Country:US
Practice Address - Phone:239-317-0265
Practice Address - Fax:239-673-7681
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111937100Medicaid