Provider Demographics
NPI:1649761099
Name:HUNTER, LAKYA S (MSSA, QMHS)
Entity Type:Individual
Prefix:
First Name:LAKYA
Middle Name:S
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MSSA, QMHS
Other - Prefix:
Other - First Name:LAKYA
Other - Middle Name:S
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSSA, QMHS
Mailing Address - Street 1:1865 N RIDGE RD E STE C
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3359
Mailing Address - Country:US
Mailing Address - Phone:440-324-1300
Mailing Address - Fax:
Practice Address - Street 1:1865 N RIDGE RD E STE C
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3359
Practice Address - Country:US
Practice Address - Phone:440-324-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator