Healthcare Provider Details

I. General information

NPI: 1083971923
Provider Name (Legal Business Name): VIRTUAL-COUNSELING.COM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2012
Last Update Date: 03/09/2024
Certification Date: 03/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18495 S DIXIE HWY # 318
CUTLER BAY FL
33157-6817
US

IV. Provider business mailing address

18495 S DIXIE HWY STE 318
CUTLER BAY FL
33157-6817
US

V. Phone/Fax

Practice location:
  • Phone: 786-258-8499
  • Fax: 888-318-4788
Mailing address:
  • Phone: 786-258-8499
  • Fax: 888-318-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH4989
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMH4989
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number801537
License Number StateFL

VIII. Authorized Official

Name: KRISTEN PATTERSON
Title or Position: MANAGER
Credential: L.M.H.C.
Phone: 786-258-8499