Healthcare Provider Details

I. General information

NPI: 1811535321
Provider Name (Legal Business Name): KIARA IVETTE NIEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIARA IVETTE NIEVES

II. Dates (important events)

Enumeration Date: 12/16/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N WOODLAND BLVD STE 400
DELAND FL
32720-4296
US

IV. Provider business mailing address

101 N WOODLAND BLVD STE 400
DELAND FL
32720-4296
US

V. Phone/Fax

Practice location:
  • Phone: 407-794-9341
  • Fax: 386-515-8431
Mailing address:
  • Phone: 407-794-9341
  • Fax: 386-515-8431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: