MEDICARE: NC COUNSELING 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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1295456051	OTHER	FL	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1811703531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NC COUNSELING LLC

Provider Business Mailing Address
First Line	:	4211 W 8TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3831
Country	:	US
Telephone Number	:	786-518-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 W 8TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3831
Country	:	US
Telephone Number	:	786-519-1419
Fax Number	:

Authorized Official
Title or Position	:	LMHC
Name	:	MRS. NAVILA CARDOSA
Credential	:
Telephone Number	:	786-518-5500

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	12/06/2024

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