Healthcare Provider Details

I. General information

NPI: 1346158508
Provider Name (Legal Business Name): CAMPAGNA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11370 SW 232ND TER
HOMESTEAD FL
33032-6000
US

IV. Provider business mailing address

11370 SW 232ND TER
HOMESTEAD FL
33032-6000
US

V. Phone/Fax

Practice location:
  • Phone: 786-519-1619
  • Fax:
Mailing address:
  • Phone: 786-519-1619
  • 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 Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SAMANTHA ELENA CAMPAGNA BONOMO
Title or Position: OWNER
Credential: LMHC-QS, LMFT-QS
Phone: 305-335-0254