Healthcare Provider Details

I. General information

NPI: 1306897392
Provider Name (Legal Business Name): ALICIA S. SEKIZAWA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 CORAL WAY STE 106
MIAMI FL
33155
US

IV. Provider business mailing address

7811 CORAL WAY
MIAMI FL
33155-6540
US

V. Phone/Fax

Practice location:
  • Phone: 305-412-0138
  • Fax: 305-412-0140
Mailing address:
  • Phone: 305-412-0138
  • Fax: 305-412-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 6547
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: