Healthcare Provider Details

I. General information

NPI: 1063088912
Provider Name (Legal Business Name): CLAUDHINE LOUIS-JEAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 TAFT ST
HOLLYWOOD FL
33024-3864
US

IV. Provider business mailing address

16220 NW 2ND AVE APT 510
NORTH MIAMI BEACH FL
33169-6539
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-0820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH19062
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: