Provider Demographics
NPI:1174669220
Name:COLON, LILIBET (LCSW)
Entity Type:Individual
Prefix:
First Name:LILIBET
Middle Name:
Last Name:COLON
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 1:5212 LAKE HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1030
Mailing Address - Country:US
Mailing Address - Phone:407-625-7034
Mailing Address - Fax:407-650-9052
Practice Address - Street 1:718 GARDEN PLZ
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4212
Practice Address - Country:US
Practice Address - Phone:407-625-7034
Practice Address - Fax:407-650-9052
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW21761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical