Provider Demographics
NPI:1437310505
Name:MINTER, LISA ALBERT (MA, LMHC, RMFTI)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ALBERT
Last Name:MINTER
Suffix:
Gender:F
Credentials:MA, LMHC, RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 WOOD RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8839
Mailing Address - Country:US
Mailing Address - Phone:407-353-9441
Mailing Address - Fax:
Practice Address - Street 1:165 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2954
Practice Address - Country:US
Practice Address - Phone:407-353-9441
Practice Address - Fax:407-353-9441
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-21
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH5816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health