Provider Demographics
NPI:1871082198
Name:DIBENARDO, NATHALIA (LMHC)
Entity type:Individual
Prefix:
First Name:NATHALIA
Middle Name:
Last Name:DIBENARDO
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3993 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9726
Mailing Address - Country:US
Mailing Address - Phone:407-732-4272
Mailing Address - Fax:
Practice Address - Street 1:3993 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9726
Practice Address - Country:US
Practice Address - Phone:386-873-2963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health