Provider Demographics
NPI:1245992247
Name:CABRERA, FERNANDO LUIS (LMHC)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:LUIS
Last Name:CABRERA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:DR
Other - First Name:FER
Other - Middle Name:LUIS
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:370 E 160TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4404
Mailing Address - Country:US
Mailing Address - Phone:718-309-3090
Mailing Address - Fax:914-302-4067
Practice Address - Street 1:3265 JOHNSON AVE STE 105
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3539
Practice Address - Country:US
Practice Address - Phone:347-449-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty