Healthcare Provider Details

I. General information

NPI: 1972848646
Provider Name (Legal Business Name): DADE FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 WEST FLAGLER STREET SUITE 100 DADE FAMILY COUNSELING
MIAMI FL
33134
US

IV. Provider business mailing address

8545 NW 169TH TER
MIAMI LAKES FL
33016-6209
US

V. Phone/Fax

Practice location:
  • Phone: 305-774-9570
  • Fax:
Mailing address:
  • Phone: 305-827-1445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberISW 1905
License Number StateFL

VIII. Authorized Official

Name: MRS. MARIA FIELDS
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 305-774-9570