Healthcare Provider Details

I. General information

NPI: 1073993119
Provider Name (Legal Business Name): CENTER FOR INDIVIDUAL AND FAMILY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SW 1ST ST STE 100
MIAMI FL
33135-2261
US

IV. Provider business mailing address

1401 SW 1ST ST STE 100
MIAMI FL
33135-2261
US

V. Phone/Fax

Practice location:
  • Phone: 305-400-8998
  • Fax: 786-360-1296
Mailing address:
  • Phone: 305-400-8998
  • Fax: 786-360-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA O IGLESIAS
Title or Position: PRESIDENT
Credential: LMHC
Phone: 305-400-8998