Provider Demographics
NPI:1821364746
Name:LYONS MCDONALD, CARIDAD AMPARO (PHD, LMHC, CFMHE)
Entity type:Individual
Prefix:MS
First Name:CARIDAD
Middle Name:AMPARO
Last Name:LYONS MCDONALD
Suffix:
Gender:F
Credentials:PHD, LMHC, CFMHE
Other - Prefix:MS
Other - First Name:CHACHI
Other - Middle Name:
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:780 DELTONA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7128
Mailing Address - Country:US
Mailing Address - Phone:386-753-3915
Mailing Address - Fax:
Practice Address - Street 1:780 DELTONA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7128
Practice Address - Country:US
Practice Address - Phone:386-753-3915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-25
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12055101YM0800X
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health