Healthcare Provider Details

I. General information

NPI: 1902074529
Provider Name (Legal Business Name): MIAMI BEACH COUNSELING ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2008
Last Update Date: 02/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 W 41ST ST SUITE 206
MIAMI BEACH FL
33140-3329
US

IV. Provider business mailing address

975 W 41ST ST SUITE 206
MIAMI BEACH FL
33140-3329
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-1314
  • Fax: 305-674-1516
Mailing address:
  • Phone: 305-674-1314
  • Fax: 305-674-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY5493
License Number StateFL

VIII. Authorized Official

Name: DR. SHERRIE LEWIS-THOMAS
Title or Position: PRESIDENT
Credential: PHD
Phone: 305-674-1314