Provider Demographics
NPI:1588446165
Name:ACOSTA, LILIANA L (PHD)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:L
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 MCGRATH BLVD APT 1120
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-8630
Mailing Address - Country:US
Mailing Address - Phone:386-872-2431
Mailing Address - Fax:
Practice Address - Street 1:6833 4TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1901
Practice Address - Country:US
Practice Address - Phone:202-729-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical