Provider Demographics
NPI:1437405065
Name:AMADOR, LOURDES BARRERA (LMHC)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:BARRERA
Last Name:AMADOR
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 1:1931 NW 150TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2873
Mailing Address - Country:US
Mailing Address - Phone:786-510-0667
Mailing Address - Fax:866-223-5131
Practice Address - Street 1:1931 NW 150TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2873
Practice Address - Country:US
Practice Address - Phone:786-510-0667
Practice Address - Fax:866-223-5131
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11635101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014572800Medicaid
FL021763700Medicaid