Provider Demographics
NPI:1386822526
Name:CESAR, MARIE K (PHD, LMHC, QS)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:K
Last Name:CESAR
Suffix:
Gender:F
Credentials:PHD, LMHC, QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 SW NEAL RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-5788
Mailing Address - Country:US
Mailing Address - Phone:786-445-8307
Mailing Address - Fax:
Practice Address - Street 1:2354 SW NEAL RD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-5788
Practice Address - Country:US
Practice Address - Phone:786-445-8307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH12138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health