Provider Demographics
NPI:1750958443
Name:CARDENAS, NICOLE CHRISTINA (LMHC)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CHRISTINA
Last Name: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 1:1180 8TH AVE W # 228
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-3810
Mailing Address - Country:US
Mailing Address - Phone:954-544-1660
Mailing Address - Fax:
Practice Address - Street 1:16 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5805
Practice Address - Country:US
Practice Address - Phone:954-544-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health