Provider Demographics
NPI:1629220850
Name:FUENTES, HAYDEE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:HAYDEE
Middle Name:
Last Name:FUENTES
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 1:20000 NW 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1543
Mailing Address - Country:US
Mailing Address - Phone:305-778-7696
Mailing Address - Fax:
Practice Address - Street 1:7950 NW 155TH ST
Practice Address - Street 2:SUITE #103
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5819
Practice Address - Country:US
Practice Address - Phone:305-778-7696
Practice Address - Fax:305-827-8787
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health