Healthcare Provider Details

I. General information

NPI: 1083969661
Provider Name (Legal Business Name): NATASHA VALENTINA GUZMAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATASHA VALENTINA FERNANDEZ LMHC

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15715 S DIXIE HWY STE 320
MIAMI FL
33157-1883
US

IV. Provider business mailing address

15443 SW 102ND PL
MIAMI FL
33157-1437
US

V. Phone/Fax

Practice location:
  • Phone: 786-475-2309
  • Fax:
Mailing address:
  • Phone: 786-663-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01237700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16597
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH16597
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: