Provider Demographics
NPI:1811538341
Name:MOSCOSO, CECILIA (LMHC)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:MOSCOSO
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 1:325 OCEAN DR APT 603
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6963
Mailing Address - Country:US
Mailing Address - Phone:786-334-3911
Mailing Address - Fax:
Practice Address - Street 1:325 OCEAN DR APT 603
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6963
Practice Address - Country:US
Practice Address - Phone:786-334-3911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17068101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty