Healthcare Provider Details

I. General information

NPI: 1700570652
Provider Name (Legal Business Name): SELENE MINOTA OROZCO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 STIRLING RD STE 103
HOLLYWOOD FL
33024-8073
US

IV. Provider business mailing address

233 NW 8TH AVE APT 307
HALLANDALE BEACH FL
33009-3943
US

V. Phone/Fax

Practice location:
  • Phone: 954-300-2921
  • Fax:
Mailing address:
  • Phone: 954-654-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH23809
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH25226
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: