Provider Demographics
NPI:1821856428
Name:BRISONET-ALEXANDER, CARLENE (LMHC)
Entity Type:Individual
Prefix:
First Name:CARLENE
Middle Name:
Last Name:BRISONET-ALEXANDER
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 1:214 NW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-6764
Mailing Address - Country:US
Mailing Address - Phone:239-784-6832
Mailing Address - Fax:
Practice Address - Street 1:214 NW 28TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-6764
Practice Address - Country:US
Practice Address - Phone:239-784-6832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health