Provider Demographics
NPI:1316501315
Name:CASTANEDA, ALEXA VIKTORIA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:VIKTORIA
Last Name:CASTANEDA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:VIKTORIA
Other - Last Name:SOLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:358 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3140
Mailing Address - Country:US
Mailing Address - Phone:305-877-7062
Mailing Address - Fax:
Practice Address - Street 1:3800 W BROWARD BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1018
Practice Address - Country:US
Practice Address - Phone:954-587-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health