Healthcare Provider Details

I. General information

NPI: 1033462130
Provider Name (Legal Business Name): JERIBETH SOLIS PEREZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YOLI JERIBETH SOLIS

II. Dates (important events)

Enumeration Date: 10/26/2012
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15715 S DIXIE HWY STE 211
MIAMI FL
33157-1875
US

IV. Provider business mailing address

21711 SW 97TH CT
CUTLER BAY FL
33190-1176
US

V. Phone/Fax

Practice location:
  • Phone: 305-910-2992
  • Fax:
Mailing address:
  • Phone: 786-626-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMH18247
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH18247
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH18247
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: