Provider Demographics
NPI:1669233565
Name:CALLEJA, LISA A (RMHCI)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:CALLEJA
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 WINDY BLUFF PT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4561
Mailing Address - Country:US
Mailing Address - Phone:407-529-4777
Mailing Address - Fax:
Practice Address - Street 1:100 E SYBELIA AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4763
Practice Address - Country:US
Practice Address - Phone:321-355-4815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health