Provider Demographics
NPI:1669838660
Name:ORDONEZ, FERNANDA (LMHC)
Entity Type:Individual
Prefix:
First Name:FERNANDA
Middle Name:
Last Name:ORDONEZ
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 1:9512 GLENN ABBEY WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6485
Mailing Address - Country:US
Mailing Address - Phone:904-859-7134
Mailing Address - Fax:
Practice Address - Street 1:225 N MICHIGAN AVE STE 1430
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7653
Practice Address - Country:US
Practice Address - Phone:904-859-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9264101YM0800X
222Q00000X
FLMH15645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist