Provider Demographics
NPI:1992456966
Name:CARDENAS NAVARRO, LUCIA (QMHP)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:CARDENAS NAVARRO
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2367
Mailing Address - Country:US
Mailing Address - Phone:603-793-8239
Mailing Address - Fax:
Practice Address - Street 1:211 N HAMMES AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8113
Practice Address - Country:US
Practice Address - Phone:603-793-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health