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General NPI Number Information
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NPI Number | 1023516051
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Entity Type | Individual
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Provider Name | YENI CORCHO AREVALO CBHCMS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 1370 W 83RD ST
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City | HIALEAH
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State | FL
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Zip | 33014-3462
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Country | US
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Telephone | 786-725-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 7382 NW 35TH TER UNIT 106
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City | MIAMI
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State | FL
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Zip | 33122-1241
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Country | US
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Telephone | 305-335-9627
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Fax | 305-402-6101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CBHCM100372
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9473880
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License Number State | FL
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