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NPI Code Detail

MEDICARE: CATALINA LASSO LMHC

MEDICARE: CATALINA LASSO 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
1101YM0800XMental Health CounselorMH14362FL

General Provider Information

NPI Number : 1629473582
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATALINA LASSO LMHC
Provider Business Mailing Address
First Line : 6718 LAKE NONA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32827-7982
Country : US
Telephone Number : 833-769-3524
Fax Number : 321-418-8926
Provider Business Practice Location Address
First Line : 6718 LAKE NONA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32827-7982
Country : US
Telephone Number : 833-769-3524
Fax Number : 321-418-8926
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2014
Last Update Date : 07/24/2025

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