Provider Demographics
NPI:1508622341
Name:LUJAN MENTAL HEALTH COUNSELOR LLC
Entity Type:Organization
Organization Name:LUJAN MENTAL HEALTH COUNSELOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALGYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ LUJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-457-2449
Mailing Address - Street 1:14241 SW 96TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7894
Mailing Address - Country:US
Mailing Address - Phone:305-457-2449
Mailing Address - Fax:
Practice Address - Street 1:14241 SW 96TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7894
Practice Address - Country:US
Practice Address - Phone:305-457-2449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty