Provider Demographics
NPI:1154553667
Name:LELLO, LISA Y (LMHC)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:Y
Last Name:LELLO
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 1:3455 ASTORIA CT
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2005
Mailing Address - Country:US
Mailing Address - Phone:407-310-4485
Mailing Address - Fax:
Practice Address - Street 1:3455 ASTORIA CT
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2005
Practice Address - Country:US
Practice Address - Phone:073-104-4485
Practice Address - Fax:717-427-4153
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11496101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional