Provider Demographics
NPI:1619394111
Name:URIBE, LILIANA L (LCSW)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:L
Last Name:URIBE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15372 SW 9TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2781
Mailing Address - Country:US
Mailing Address - Phone:786-635-9058
Mailing Address - Fax:
Practice Address - Street 1:2555 NW 102ND AVE STE 205
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2131
Practice Address - Country:US
Practice Address - Phone:786-635-9058
Practice Address - Fax:305-489-8065
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11599101YM0800X, 103K00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst