Healthcare Provider Details
I. General information
NPI: 1659106755
Provider Name (Legal Business Name): DE LIMA COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 FRONT ST STE 300
JUPITER FL
33477-5095
US
IV. Provider business mailing address
131 PENNOCK LANDING CIR
JUPITER FL
33458-4019
US
V. Phone/Fax
- Phone: 561-972-7195
- Fax:
- Phone: 561-201-8209
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANNA LISA
DE LIMA
Title or Position: OWNER
Credential: PHD, LMHC, LPC
Phone: 561-201-8209