Healthcare Provider Details

I. General information

NPI: 1972925188
Provider Name (Legal Business Name): FAMILY COUNSELING CENTRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 SW 81ST DR STE 290
MIAMI FL
33143-6603
US

IV. Provider business mailing address

8100 SW 81ST DR STE 290
MIAMI FL
33143-6603
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-7968
  • Fax: 305-270-2540
Mailing address:
  • Phone: 305-270-7968
  • Fax: 305-270-2540

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: MRS. DIANA A DE CARDENAS
Title or Position: DIRECTOR
Credential: LMHC,LMFT
Phone: 305-270-7968