Provider Demographics
NPI:1710288717
Name:LLOYD, GRISSEL M (MA, BCBA, CAP)
Entity Type:Individual
Prefix:
First Name:GRISSEL
Middle Name:M
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MA, BCBA, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-5649
Mailing Address - Country:US
Mailing Address - Phone:347-779-2477
Mailing Address - Fax:
Practice Address - Street 1:2001 MERCY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-5649
Practice Address - Country:US
Practice Address - Phone:347-779-2477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-06
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4907101YA0400X
FLIMH7514101YM0800X
FL1-04-1968103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health