Provider Demographics
NPI:1588966808
Name:BOCANEGRA, CYNTHIA BAEMI (LMHC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:BAEMI
Last Name:BOCANEGRA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:BAEMI
Other - Last Name:BOCANEGRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1277 N SEMORAN BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3569
Mailing Address - Country:US
Mailing Address - Phone:407-601-7748
Mailing Address - Fax:407-601-7749
Practice Address - Street 1:1277 N SEMORAN BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3569
Practice Address - Country:US
Practice Address - Phone:407-601-7748
Practice Address - Fax:407-601-7749
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10506101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional