Provider Demographics
NPI:1801471768
Name:ALARCON, CELICA ANDREA
Entity type:Individual
Prefix:
First Name:CELICA
Middle Name:ANDREA
Last Name:ALARCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10540 SW 93RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2608
Mailing Address - Country:US
Mailing Address - Phone:305-562-8538
Mailing Address - Fax:
Practice Address - Street 1:4649 PONCE DE LEON BLVD STE 404
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2121
Practice Address - Country:US
Practice Address - Phone:786-536-9714
Practice Address - Fax:786-536-9833
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health