Provider Demographics
NPI:1699022715
Name:HERNANDEZ-LECUSAY, ANA M (COUNSELOR, MA)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:HERNANDEZ-LECUSAY
Suffix:
Gender:F
Credentials:COUNSELOR, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13894 RED MANGROVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7389
Mailing Address - Country:US
Mailing Address - Phone:407-506-6345
Mailing Address - Fax:
Practice Address - Street 1:13894 RED MANGROVE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7389
Practice Address - Country:US
Practice Address - Phone:407-506-6345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1161023101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor