MEDICARE: JOAN KALFUS LMHC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	MH3160	FL
2	101YM0800X	Mental Health Counselor	MH3160	FL
3	101YP2500X	Professional Counselor	MH3160	FL
4	106H00000X	Marriage & Family Therapist	MH3160	FL

General Provider Information

NPI Number	:	1871722744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN KALFUS LMHC

Provider Business Mailing Address
First Line	:	952 NE 199TH ST
Second Line	:	STE 110
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-3077
Country	:	US
Telephone Number	:	305-206-7087
Fax Number	:	305-653-0506

Provider Business Practice Location Address
First Line	:	1031 IVES DAIRY RD
Second Line	:	STE 228
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-2538
Country	:	US
Telephone Number	:	305-206-7087
Fax Number	:	305-653-0506

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

Provider Enumeration Date	:	07/13/2009
Last Update Date	:	07/12/2012

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