Provider Demographics
NPI:1790891349
Name:ADLER, LOIS (MED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:
Last Name:ADLER
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE 98
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1824
Mailing Address - Country:US
Mailing Address - Phone:954-689-6667
Mailing Address - Fax:954-689-6762
Practice Address - Street 1:2400 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 98
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1824
Practice Address - Country:US
Practice Address - Phone:954-689-6667
Practice Address - Fax:954-689-6762
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0000805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH0000805OtherPROFESSIONAL LICENSE