Provider Demographics
NPI:1164055547
Name:CERNE CONSTANTIN, KERY (LMHC)
Entity type:Individual
Prefix:MR
First Name:KERY
Middle Name:
Last Name:CERNE CONSTANTIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:KC
Other - Middle Name:
Other - Last Name:CONSTANTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:8403 PINES BLVD
Mailing Address - Street 2:#106
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6609
Mailing Address - Country:US
Mailing Address - Phone:305-419-6446
Mailing Address - Fax:305-419-6446
Practice Address - Street 1:16800 NE 15TH AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2968
Practice Address - Country:US
Practice Address - Phone:305-419-6446
Practice Address - Fax:305-419-6446
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health