Healthcare Provider Details

I. General information

NPI: 1407392111
Provider Name (Legal Business Name): MS. DHAIMA CHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20535 NW 2ND AVE STE 210
MIAMI FL
33169-2547
US

IV. Provider business mailing address

20295 NW 2ND AVE STE 302
MIAMI FL
33169-2552
US

V. Phone/Fax

Practice location:
  • Phone: 305-900-3475
  • Fax:
Mailing address:
  • Phone: 305-900-3475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13760
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14083193-3501
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW008650.
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118894
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-20327
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW124722.
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: