Healthcare Provider Details

I. General information

NPI: 1902732209
Provider Name (Legal Business Name): WILLIAMSBURG THERAPY GROUP MIAMI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3390 MARY ST STE 116
COCONUT GROVE FL
33133-5255
US

IV. Provider business mailing address

10 OAKWOOD DR
LLOYD HARBOR NY
11743-9748
US

V. Phone/Fax

Practice location:
  • Phone: 305-363-1221
  • Fax:
Mailing address:
  • Phone: 718-757-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL SELLING
Title or Position: FOUNDER
Credential: PSYD
Phone: 718-757-7033