Provider Demographics
NPI:1588047633
Name:CEDENO, ELEDYS (LMHC)
Entity type:Individual
Prefix:MS
First Name:ELEDYS
Middle Name:
Last Name:CEDENO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:ELEDYS
Other - Middle Name:
Other - Last Name:LABRADOR HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:5595 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5307
Practice Address - Country:US
Practice Address - Phone:542-763-4009
Practice Address - Fax:954-965-6444
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015231100Medicaid