Healthcare Provider Details

I. General information

NPI: 1447810023
Provider Name (Legal Business Name): CRYSTAL CISNEROS LMFT-QS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRYSTAL FERRO

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 02/08/2025
Certification Date: 02/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 SW 8TH ST SHC 270
MIAMI FL
33199-1436
US

IV. Provider business mailing address

9940 NW 9TH STREET CIR APT 101
MIAMI FL
33172-5106
US

V. Phone/Fax

Practice location:
  • Phone: 305-348-2277
  • Fax:
Mailing address:
  • Phone: 786-999-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT2461
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT3986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: