Healthcare Provider Details

I. General information

NPI: 1376145219
Provider Name (Legal Business Name): KAROLYNNE LARREA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 SHERIDAN ST
HOLLYWOOD FL
33020-2113
US

IV. Provider business mailing address

654 NE 191ST TER
MIAMI FL
33179-3972
US

V. Phone/Fax

Practice location:
  • Phone: 844-524-6873
  • Fax:
Mailing address:
  • Phone: 754-244-0129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: