Healthcare Provider Details

I. General information

NPI: 1346692159
Provider Name (Legal Business Name): SEEDS OF HOPE BEHAVIORAL HEALTH, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PONCE DE LEON BLVD SUITE: 605
CORAL GABLES FL
33134-4422
US

IV. Provider business mailing address

2000 PONCE DE LEON BLVD SUITE: 605
CORAL GABLES FL
33134-4422
US

V. Phone/Fax

Practice location:
  • Phone: 305-421-6354
  • Fax:
Mailing address:
  • Phone: 305-421-6354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14084
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 9410
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 13260
License Number StateFL

VIII. Authorized Official

Name: MRS. ZULAYMIS MIGOYO
Title or Position: THERAPIST
Credential: LMHC
Phone: 305-421-6354