Provider Demographics
NPI:1457827727
Name:PENAGOS-CHINCHILLA, IBLIN (LMHC)
Entity Type:Individual
Prefix:
First Name:IBLIN
Middle Name:
Last Name:PENAGOS-CHINCHILLA
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 1:8203 SUN SPRING CIRCLE
Mailing Address - Street 2:UNIT 82
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:954-682-0597
Mailing Address - Fax:
Practice Address - Street 1:8203 SUN SPRING CIRCLE
Practice Address - Street 2:UNIT 82
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825
Practice Address - Country:US
Practice Address - Phone:401-732-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)