Healthcare Provider Details

I. General information

NPI: 1609696780
Provider Name (Legal Business Name): LISA PATRICIA LIONELLI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 STATE ROAD 54 STE 307
NEW PORT RICHEY FL
34655-1810
US

IV. Provider business mailing address

9332 STATE ROAD 54 STE 307
NEW PORT RICHEY FL
34655-1810
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax: 727-478-4966
Mailing address:
  • Phone: 833-769-3524
  • Fax: 727-478-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: