Provider Demographics
NPI:1164713160
Name:HERNANDEZ, CAROLINA (LPCC)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1208
Mailing Address - Country:US
Mailing Address - Phone:855-469-3242
Mailing Address - Fax:855-324-2329
Practice Address - Street 1:118 S WATER ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1208
Practice Address - Country:US
Practice Address - Phone:855-469-3242
Practice Address - Fax:855-324-2329
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0112401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health