Provider Demographics
NPI:1417722034
Name:LUGO, RHONDA LATRESE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LATRESE
Last Name:LUGO
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 1:1020 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-5104
Mailing Address - Country:US
Mailing Address - Phone:229-254-6024
Mailing Address - Fax:
Practice Address - Street 1:1020 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-5104
Practice Address - Country:US
Practice Address - Phone:229-254-6024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23597101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health