Provider Demographics
NPI:1811244676
Name:ORTEGA, PATRICIA LEON (LMHC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEON
Last Name:ORTEGA
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 1:5440 SW 153RD AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4115
Mailing Address - Country:US
Mailing Address - Phone:305-794-7078
Mailing Address - Fax:
Practice Address - Street 1:14221 SW 120TH ST
Practice Address - Street 2:SUITE 219
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7236
Practice Address - Country:US
Practice Address - Phone:305-240-7980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-11
Last Update Date:2012-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11337101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health