Provider Demographics
NPI:1942724869
Name:FERNANDEZ, BEATRICE (LMHC)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:FERNANDEZ
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 1:18503 PINES BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1406
Mailing Address - Country:US
Mailing Address - Phone:954-740-3452
Mailing Address - Fax:
Practice Address - Street 1:13501 SW 128TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5882
Practice Address - Country:US
Practice Address - Phone:786-250-3440
Practice Address - Fax:786-364-1810
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 101YA0400X
FLMH15236101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH15236OtherLMHC