Healthcare Provider Details

I. General information

NPI: 1184545899
Provider Name (Legal Business Name): DESIREE MANTOVANI LMHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 NW 87TH AVE APT 204
MIAMI FL
33172-2425
US

IV. Provider business mailing address

1002 NW 87TH AVE APT 204
MIAMI FL
33172-2425
US

V. Phone/Fax

Practice location:
  • Phone: 786-238-1936
  • 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

VIII. Authorized Official

Name: DESIREE MANTOVANI
Title or Position: CLINICIAN
Credential: LMHC
Phone: 786-238-1936