Provider Demographics
NPI:1306195201
Name:HERNANDEZ, CESIAH (LPCA)
Entity Type:Individual
Prefix:
First Name:CESIAH
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9003 WESTON PKWY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2201
Mailing Address - Country:US
Mailing Address - Phone:919-677-1400
Mailing Address - Fax:919-677-1489
Practice Address - Street 1:9003 WESTON PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2201
Practice Address - Country:US
Practice Address - Phone:919-677-1400
Practice Address - Fax:919-677-1489
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRMHCI 5397101YM0800X
NCA11646101YP2500X
NC11646101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional