Provider Demographics
NPI:1487931747
Name:TRAYNOR, ELIZABETH A (LMHC, LMFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:TRAYNOR
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32790-0144
Mailing Address - Country:US
Mailing Address - Phone:407-628-3443
Mailing Address - Fax:407-628-8956
Practice Address - Street 1:1331 PALMETTO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4963
Practice Address - Country:US
Practice Address - Phone:407-628-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3154101YP2500X
FLMT1877101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional