Healthcare Provider Details

I. General information

NPI: 1942146972
Provider Name (Legal Business Name): AWVEAN FARSHADI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

7369 SHERIDAN ST
HOLLYWOOD FL
33024-2776
US

IV. Provider business mailing address

7369 SHERIDAN ST
HOLLYWOOD FL
33024-2776
US

V. Phone/Fax

Practice location:
  • Phone: 954-531-6521
  • Fax:
Mailing address:
  • Phone: 954-531-6521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: