Provider Demographics
NPI:1780312322
Name:MOJICAS MENTAL HEALTH COUNSELING
Entity type:Organization
Organization Name:MOJICAS MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOJICA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:315-558-7374
Mailing Address - Street 1:1333 NW 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-5042
Mailing Address - Country:US
Mailing Address - Phone:315-558-7374
Mailing Address - Fax:315-748-5366
Practice Address - Street 1:1333 NW 15TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-5042
Practice Address - Country:US
Practice Address - Phone:315-558-7374
Practice Address - Fax:315-748-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty