Healthcare Provider Details

I. General information

NPI: 1043177256
Provider Name (Legal Business Name): AUTHENTIC GROWTH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9321 SW 13TH ST
MIAMI FL
33174-3003
US

IV. Provider business mailing address

9321 SW 13TH ST
MIAMI FL
33174-3003
US

V. Phone/Fax

Practice location:
  • Phone: 786-757-5104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: YESENIA DELGADO
Title or Position: CEO
Credential: LMFT, M.S.
Phone: 786-757-5104