Healthcare Provider Details

I. General information

NPI: 1437751666
Provider Name (Legal Business Name): KRYSTINE N GARAY LMHC,LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRYSTINE N GARCIA RMHCI,RMFTI

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SW 107TH AVE STE 42
MIAMI FL
33165-2492
US

IV. Provider business mailing address

2500 SW 107TH AVE STE 42
MIAMI FL
33165-2492
US

V. Phone/Fax

Practice location:
  • Phone: 786-615-3334
  • Fax:
Mailing address:
  • Phone: 786-383-2891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH20561
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: