Healthcare Provider Details

I. General information

NPI: 1952076622
Provider Name (Legal Business Name): MAILIN DELGADO ED.S., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 MYSTIC POINTE DR
AVENTURA FL
33180-2554
US

IV. Provider business mailing address

1124 NE 183RD ST
NORTH MIAMI BEACH FL
33179-4612
US

V. Phone/Fax

Practice location:
  • Phone: 786-702-4383
  • Fax:
Mailing address:
  • Phone: 786-487-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH18544
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS1539
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: