Provider Demographics
NPI:1780438069
Name:TRINCA-PIERSON, LISA (LMHC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:TRINCA-PIERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5921
Mailing Address - Country:US
Mailing Address - Phone:954-483-0192
Mailing Address - Fax:
Practice Address - Street 1:702 SW 122ND AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-5921
Practice Address - Country:US
Practice Address - Phone:954-483-0192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health