Provider Demographics
NPI:1609140110
Name:LIRIANO, PRICILLA (LCSW, BCABA, LABA)
Entity Type:Individual
Prefix:
First Name:PRICILLA
Middle Name:
Last Name:LIRIANO
Suffix:
Gender:F
Credentials:LCSW, BCABA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14325 SW 52ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5820
Mailing Address - Country:US
Mailing Address - Phone:786-734-2777
Mailing Address - Fax:
Practice Address - Street 1:173 MCELMURRAY RD
Practice Address - Street 2:
Practice Address - City:BEECH ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29842-8380
Practice Address - Country:US
Practice Address - Phone:786-734-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000369106E00000X
FLSW180551041C0700X
0-20-10723106E00000X
SCSW.14101CP1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst