MEDICARE: MBS COUNSELING & FAMILY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376967877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MBS COUNSELING & FAMILY CENTER, LLC

Provider Business Mailing Address
First Line	:	13022 NW 6TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-3107
Country	:	US
Telephone Number	:	954-547-3479
Fax Number	:	954-416-7846

Provider Business Practice Location Address
First Line	:	11820 MIRAMAR PKWY STE 224
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-5818
Country	:	US
Telephone Number	:	954-547-3479
Fax Number	:	954-416-7846

Authorized Official
Title or Position	:	CEO
Name	:	VALARIE D FIELDS ERVIN
Credential	:
Telephone Number	:	954-547-3479

Provider Enumeration Date	:	02/05/2014
Last Update Date	:	03/01/2022

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