Provider Demographics
NPI:1467660944
Name:ALLEVA, LISA (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ALLEVA
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 LINTON BLVD. SUITE 205
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444
Mailing Address - Country:US
Mailing Address - Phone:561-350-9567
Mailing Address - Fax:
Practice Address - Street 1:900 LINTON BLVD STE 205
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-8165
Practice Address - Country:US
Practice Address - Phone:561-350-9567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist