Provider Demographics
NPI:1366720195
Name:HERNANDEZ, JESENIA MARLENE (MS, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JESENIA
Middle Name:MARLENE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14750 SW 26TH ST STE 215
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5937
Mailing Address - Country:US
Mailing Address - Phone:305-392-0445
Mailing Address - Fax:305-392-0391
Practice Address - Street 1:14750 SW 26TH ST STE 215
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5937
Practice Address - Country:US
Practice Address - Phone:305-392-0445
Practice Address - Fax:305-392-0391
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health