Provider Demographics
NPI:1609832864
Name:LERER, LORENA TAMARA (LMHC)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:TAMARA
Last Name:LERER
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 1:10740 SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4959
Mailing Address - Country:US
Mailing Address - Phone:954-895-3856
Mailing Address - Fax:954-885-7888
Practice Address - Street 1:2699 STIRLING RD
Practice Address - Street 2:SUITE C 105
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6517
Practice Address - Country:US
Practice Address - Phone:305-558-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7571OtherLICENSE NUMBER-LMHC