Provider Demographics
NPI:1811267602
Name:CARDENAS COUNSELING AND CONSULTATION
Entity type:Organization
Organization Name:CARDENAS COUNSELING AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-812-0608
Mailing Address - Street 1:8390 SW 72ND AVE
Mailing Address - Street 2:APT 523
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13350 SW 88TH TER
Practice Address - Street 2:SUITE 220
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1783
Practice Address - Country:US
Practice Address - Phone:305-785-4416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2504251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health