Healthcare Provider Details

I. General information

NPI: 1780528810
Provider Name (Legal Business Name): HARVARD INTERNATIONAL ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260B STIRLING RD STE B
HOLLYWOOD FL
33021-2041
US

IV. Provider business mailing address

3260B STIRLING RD STE B
HOLLYWOOD FL
33021-2041
US

V. Phone/Fax

Practice location:
  • Phone: 954-966-0017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: INGRID MASON
Title or Position: OWNER
Credential:
Phone: 954-966-0017