MEDICARE: ALICIA CAMERON LESNIAK M.S., L.M.H.C.

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	IMH 9803	FL
2	101YM0800X	Mental Health Counselor	MH 12418	FL

General Provider Information

NPI Number	:	1760734115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA CAMERON LESNIAK M.S., L.M.H.C.

Provider Business Mailing Address
First Line	:	333 NE 24TH ST
Second Line	:	APT 1404
City	:	MIAMI
State	:	FL
Zip	:	33137-4859
Country	:	US
Telephone Number	:	305-323-1333
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 NE 40TH ST
Second Line	:	SUITE 202
City	:	MIAMI
State	:	FL
Zip	:	33137-3502
Country	:	US
Telephone Number	:	305-323-1333
Fax Number	:

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

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	05/01/2014

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