Provider Demographics
NPI:1144905423
Name:SARDINAS, MARICRUZ (LMHC)
Entity type:Individual
Prefix:
First Name:MARICRUZ
Middle Name:
Last Name:SARDINAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 SW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6033
Mailing Address - Country:US
Mailing Address - Phone:786-487-6978
Mailing Address - Fax:305-964-7375
Practice Address - Street 1:12360 SW 132ND CT STE 113
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6461
Practice Address - Country:US
Practice Address - Phone:305-588-4143
Practice Address - Fax:305-964-7375
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health