Provider Demographics
NPI:1891135984
Name:INGUANZO, YELENA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:YELENA
Middle Name:
Last Name:INGUANZO
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 1:306 WESTWARD DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5262
Mailing Address - Country:US
Mailing Address - Phone:786-633-5992
Mailing Address - Fax:786-420-2151
Practice Address - Street 1:306 WESTWARD DR
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-5262
Practice Address - Country:US
Practice Address - Phone:786-633-5992
Practice Address - Fax:786-420-2151
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8608101YM0800X
FLMH8608103K00000X
FL104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator