Healthcare Provider Details

I. General information

NPI: 1609140110
Provider Name (Legal Business Name): PRICILLA LIRIANO LCSW, BCABA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 MCELMURRAY RD
BEECH ISLAND SC
29842-8380
US

IV. Provider business mailing address

14325 SW 52ND ST
MIAMI FL
33175-5820
US

V. Phone/Fax

Practice location:
  • Phone: 786-734-2777
  • Fax:
Mailing address:
  • Phone: 786-734-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW18055
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904013149
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW008291
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW.14101CP
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: