Provider Demographics
NPI:1013760966
Name:HERNANDEZ, MIOSOTYS CHARLENE (LMHC)
Entity Type:Individual
Prefix:
First Name:MIOSOTYS
Middle Name:CHARLENE
Last Name:HERNANDEZ
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 1:90 HAVERFORD RD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3430
Mailing Address - Country:US
Mailing Address - Phone:646-963-7156
Mailing Address - Fax:
Practice Address - Street 1:90 HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3430
Practice Address - Country:US
Practice Address - Phone:646-963-7156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014505101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health