MEDICARE: MS. STACY WEIN J.D.,M.S.,L.M.H.C.

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	MH4954	FL

General Provider Information

NPI Number	:	1841559457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STACY WEIN J.D.,M.S.,L.M.H.C.

Provider Business Mailing Address
First Line	:	2000 ISLAND BLVD
Second Line	:	APT. 3003
City	:	AVENTURA
State	:	FL
Zip	:	33160-4957
Country	:	US
Telephone Number	:	305-926-2218
Fax Number	:	954-467-1506

Provider Business Practice Location Address
First Line	:	2000 ISLAND BLVD
Second Line	:	APT. 3003
City	:	AVENTURA
State	:	FL
Zip	:	33160-4957
Country	:	US
Telephone Number	:	305-926-2218
Fax Number	:	954-467-1506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2012
Last Update Date	:	05/16/2012

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