Provider Demographics
NPI:1194492405
Name:CEDENO, ALEXANDRA (LMHC, QS)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:
Last Name:CEDENO
Suffix:
Gender:F
Credentials:LMHC, QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 WORCESTER WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6747
Mailing Address - Country:US
Mailing Address - Phone:321-693-4552
Mailing Address - Fax:
Practice Address - Street 1:1230 WORCESTER WAY
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6747
Practice Address - Country:US
Practice Address - Phone:321-693-4552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11887101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health