Provider Demographics
NPI:1750002176
Name:IGLESIAS, NAYDA LUCERO (PHD, LMHC)
Entity type:Individual
Prefix:
First Name:NAYDA
Middle Name:LUCERO
Last Name:IGLESIAS
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10760 BRUNELLO PL APT 306
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9409
Mailing Address - Country:US
Mailing Address - Phone:787-525-8362
Mailing Address - Fax:
Practice Address - Street 1:1035 S STATE ROAD 7 STE 315
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6137
Practice Address - Country:US
Practice Address - Phone:787-525-8362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health