Healthcare Provider Details

I. General information

NPI: 1336688431
Provider Name (Legal Business Name): LIA CORYN BIGELOW LPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIA CORYN LAVASSAUR LPC, LMHC

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2161 PALM BEACH LAKES BLVD STE 208
WEST PALM BEACH FL
33409-6611
US

IV. Provider business mailing address

2161 PALM BCH LK BLVD STE 208
WEST PALM BEACH FL
33409-6611
US

V. Phone/Fax

Practice location:
  • Phone: 561-899-3199
  • Fax:
Mailing address:
  • Phone: 561-584-1585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009337
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH17273
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10006597
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number003719-2014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: