Provider Demographics
NPI:1063184521
Name:DAMIANI-TINNEY, LIA ARIANA (LMHC)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:ARIANA
Last Name:DAMIANI-TINNEY
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 1:408 NE 6TH ST UNIT 312
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-6405
Mailing Address - Country:US
Mailing Address - Phone:305-395-2023
Mailing Address - Fax:
Practice Address - Street 1:408 NE 6TH ST UNIT 312
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-6405
Practice Address - Country:US
Practice Address - Phone:305-302-4987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health