Provider Demographics
NPI:1598075319
Name:NEGRON, JUDITH CRUZ (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:CRUZ
Last Name:NEGRON
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 1:1801 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1000
Mailing Address - Country:US
Mailing Address - Phone:305-371-5777
Mailing Address - Fax:305-371-6007
Practice Address - Street 1:1801 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1000
Practice Address - Country:US
Practice Address - Phone:305-371-5777
Practice Address - Fax:305-371-6007
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7202101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL765517700Medicaid