Cary P. Ballesteros, ED.S LMHC RPT-S

Individual provider Active NPI Mental Health Counselor · Pinecrest, FL

NPI 1467994657 · NPPES record last updated Nov 6, 2016

Key facts

NPI
1467994657
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MH 5858 (FL)
Practice address
12651 S Dixie Hwy Ste 307
Pinecrest, FL 33156-5961
Phone
(305) 233-4233
NPI assigned
Nov 6, 2016
Sex
Female
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
MH 5858FLMDMental Health Counselor
SS 517FLMDSchool Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 5858 FL Yes
School Psychologist 103TS0200X SS 517 FL

Addresses

Primary practice location

12651 S Dixie Hwy Ste 307
Pinecrest, FL 33156-5961

Mailing address

12651 S Dixie Hwy Ste 307
Pinecrest, FL 33156-5961
Phone (305) 233-4233

Other providers in Pinecrest, FL

All providers in Pinecrest, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.