Provider Demographics
NPI:1821136847
Name:MONTERO, LUZ MARINA (NCC, LMHC, CAP)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:MARINA
Last Name:MONTERO
Suffix:
Gender:F
Credentials:NCC, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11903 DEBARY CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-7655
Mailing Address - Country:US
Mailing Address - Phone:407-616-1120
Mailing Address - Fax:407-238-1868
Practice Address - Street 1:11903 DEBARY CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-7655
Practice Address - Country:US
Practice Address - Phone:407-616-1120
Practice Address - Fax:407-238-1868
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7643764Medicaid