Cristobal R. Fernandez, LCPC

Individual provider Active NPI Mental Health Counselor · Montgomery Village, MD

NPI 1467246017 · NPPES record last updated Apr 28, 2025

Key facts

NPI
1467246017
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
15243 (MD)
Practice address
9528 Duffer Way
Montgomery Village, MD 20886-1312
Phone
(202) 316-0347
NPI assigned
Apr 8, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15243MDMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 15243 MD Yes

Addresses

Primary practice location

9528 Duffer Way
Montgomery Village, MD 20886-1312

Mailing address

9528 Duffer Way
Montgomery Village, MD 20886-1312
Phone (202) 316-0347

Other providers in Montgomery Village, MD

All providers in Montgomery Village, MD · Mental Health Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.