Provider Demographics
NPI:1114437191
Name:HERNANDEZ, INGRID (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8570 STIRLING RD STE 102-376
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8203
Mailing Address - Country:US
Mailing Address - Phone:786-383-3455
Mailing Address - Fax:
Practice Address - Street 1:8570 STIRLING RD STE 102-376
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8203
Practice Address - Country:US
Practice Address - Phone:786-383-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8226101YM0800X
FLMH17649101YM0800X
WALH61254759101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health