Healthcare Provider Details

I. General information

NPI: 1003426198
Provider Name (Legal Business Name): JEANETTE O'FLAHERTY LMHC, NCC, CBHCMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 09/29/2026
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W BROWARD BLVD STE 100
FORT LAUDERDALE FL
33312-1018
US

IV. Provider business mailing address

4395 PUU LANI PL
KALAHEO HI
96741-8722
US

V. Phone/Fax

Practice location:
  • Phone: 954-587-1008
  • Fax: 954-208-5673
Mailing address:
  • Phone: 786-302-3500
  • Fax: 786-302-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH24118
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: