Provider Demographics
NPI:1700532751
Name:AMPARADO, LIZETTE
Entity type:Individual
Prefix:
First Name:LIZETTE
Middle Name:
Last Name:AMPARADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BOWDOIN RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2302
Mailing Address - Country:US
Mailing Address - Phone:516-721-7784
Mailing Address - Fax:
Practice Address - Street 1:6 BOWDOIN RD
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2302
Practice Address - Country:US
Practice Address - Phone:516-721-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health