Healthcare Provider Details

I. General information

NPI: 1003104308
Provider Name (Legal Business Name): CMET, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 NE 4TH AVE
FORT LAUDERDALE FL
33304-1035
US

IV. Provider business mailing address

1527 NE 4TH AVE
FORT LAUDERDALE FL
33304-1035
US

V. Phone/Fax

Practice location:
  • Phone: 954-835-5741
  • Fax: 954-835-5746
Mailing address:
  • Phone: 954-835-5741
  • Fax: 954-835-5746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMH8045
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8045
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH8045
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH8045
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARLA LOPEZ-BRINKERHOFF
Title or Position: CFO / CLINICAL DIRECTOR
Credential: LMHC
Phone: 954-835-5746