Provider Demographics
NPI:1487043014
Name:MENDEZ, SYMONE (LMHC)
Entity Type:Individual
Prefix:
First Name:SYMONE
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SYMONE
Other - Middle Name:
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:3550 W EAU GALLIE BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-7298
Mailing Address - Country:US
Mailing Address - Phone:321-426-0359
Mailing Address - Fax:321-426-0359
Practice Address - Street 1:3550 W EAU GALLIE BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-7298
Practice Address - Country:US
Practice Address - Phone:321-426-0359
Practice Address - Fax:321-426-0359
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health