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General NPI Number Information
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NPI Number | 1548147283
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Entity Type | Individual
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Provider Name | JENNIFER PRADA-MORENO PHD, LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 11550 SW 26TH ST APT 210
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City | MIRAMAR
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State | FL
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Zip | 33025-7537
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Country | US
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Telephone | 786-238-1604
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N SUITE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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