Healthcare Provider Details

I. General information

NPI: 1003436445
Provider Name (Legal Business Name): C&C MENTAL AND FAMILY SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12150 SW 128TH CT STE 228
MIAMI FL
33186-4674
US

IV. Provider business mailing address

3148 SW 143RD PL
MIAMI FL
33175-7435
US

V. Phone/Fax

Practice location:
  • Phone: 786-227-6314
  • Fax:
Mailing address:
  • Phone: 786-712-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NORMA LLERENA
Title or Position: PRESIDENT
Credential: CBHCMS
Phone: 786-712-7151