Provider Demographics
NPI:1477990653
Name:CARDENTEY, DIOSMARY (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DIOSMARY
Middle Name:
Last Name:CARDENTEY
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 1:330 W SUGARLAND HWY
Mailing Address - Street 2:SUITE #3
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-3000
Mailing Address - Country:US
Mailing Address - Phone:863-228-6934
Mailing Address - Fax:
Practice Address - Street 1:330 W SUGARLAND HWY
Practice Address - Street 2:SUITE #3
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3000
Practice Address - Country:US
Practice Address - Phone:863-228-6934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008872200Medicaid