Provider Demographics
NPI:1457521528
Name:DE CARDENAS, ELENA M (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:M
Last Name:DE CARDENAS
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 1:745 W 69TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4818
Mailing Address - Country:US
Mailing Address - Phone:305-979-2569
Mailing Address - Fax:
Practice Address - Street 1:430 W 66TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6646
Practice Address - Country:US
Practice Address - Phone:305-558-2480
Practice Address - Fax:305-558-5052
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9337101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health