Healthcare Provider Details

I. General information

NPI: 1053230151
Provider Name (Legal Business Name): MONIQUE DEFELICE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W CAMINO REAL # 1087
BOCA RATON FL
33432-5942
US

IV. Provider business mailing address

160 W CAMINO REAL # 1087
BOCA RATON FL
33432-5942
US

V. Phone/Fax

Practice location:
  • Phone: 561-870-0565
  • Fax:
Mailing address:
  • Phone: 561-870-0565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: