Provider Demographics
NPI:1902920572
Name:SERNA, JAIRO (LCSW, LMFT)
Entity Type:Individual
Prefix:MR
First Name:JAIRO
Middle Name:
Last Name:SERNA
Suffix:
Gender:M
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 BRICKELL AVE
Mailing Address - Street 2:SUITE 16-G
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2436
Mailing Address - Country:US
Mailing Address - Phone:954-937-8867
Mailing Address - Fax:954-905-4399
Practice Address - Street 1:356 ALHAMBRA CIR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5004
Practice Address - Country:US
Practice Address - Phone:786-397-6046
Practice Address - Fax:954-905-4399
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2014-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2274106H00000X
FLSW70201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ031EOtherBLUE CROSS BLUE SHIELD