MEDICARE: LISA LOZANO CZULINSKI LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	014687	NY

General Provider Information

NPI Number	:	1407688252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LOZANO CZULINSKI LMHC

Provider Business Mailing Address
First Line	:	339 TARRYTOWN RD # 1106
Second Line	:
City	:	ELMSFORD
State	:	NY
Zip	:	10523-3417
Country	:	US
Telephone Number	:	917-222-1217
Fax Number	:

Provider Business Practice Location Address
First Line	:	339 TARRYTOWN RD # 1106
Second Line	:
City	:	ELMSFORD
State	:	NY
Zip	:	10523-3417
Country	:	US
Telephone Number	:	917-222-1217
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	08/19/2024

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