Provider Demographics
NPI:1912753294
Name:CARMO, LEAH ALFIERI
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:ALFIERI
Last Name:CARMO
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 1:841 S ATLANTIC DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1966
Mailing Address - Country:US
Mailing Address - Phone:561-346-7244
Mailing Address - Fax:
Practice Address - Street 1:631 LUCERNE AVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33460-3820
Practice Address - Country:US
Practice Address - Phone:156-134-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health