Healthcare Provider Details

I. General information

NPI: 1235836156
Provider Name (Legal Business Name): MONICA ISABELLA ESCOBAR LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 NW 15TH ST
MIAMI FL
33136-1431
US

IV. Provider business mailing address

8600 SW 103RD ST
MIAMI FL
33156-2439
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-1818
  • Fax:
Mailing address:
  • Phone: 786-838-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License NumberMH20918
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH20918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: