Healthcare Provider Details

I. General information

NPI: 1871426882
Provider Name (Legal Business Name): GENEVA COMEAU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20606 NE 6TH CT
MIAMI FL
33179-2416
US

IV. Provider business mailing address

20606 NE 6TH CT
MIAMI FL
33179-2416
US

V. Phone/Fax

Practice location:
  • Phone: 305-784-6223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH17979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: