Provider Demographics
NPI:1285405498
Name:ESTRADA, GISELLE (LMHC)
Entity type:Individual
Prefix:MS
First Name:GISELLE
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:GISELLE
Other - Middle Name:
Other - Last Name:ESTRADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:727 SW 98TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1994
Mailing Address - Country:US
Mailing Address - Phone:786-804-0005
Mailing Address - Fax:
Practice Address - Street 1:250 CATALONIA AVE STE 403
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6730
Practice Address - Country:US
Practice Address - Phone:321-405-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health