Provider Demographics
NPI:1265861462
Name:FUENTES, MONICA (LMHC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:FUENTES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18901 SW 106TH AVE STE 224
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7665
Mailing Address - Country:US
Mailing Address - Phone:786-732-0071
Mailing Address - Fax:305-964-5435
Practice Address - Street 1:18901 SW 106TH AVE STE 224
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7665
Practice Address - Country:US
Practice Address - Phone:786-732-0071
Practice Address - Fax:305-964-5435
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 9778101YM0800X
FLMH13706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011938200Medicaid