Healthcare Provider Details

I. General information

NPI: 1861763435
Provider Name (Legal Business Name): NEW HORIZONS COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11921 S DIXIE HWY STE 215
PINECREST FL
33156-4449
US

IV. Provider business mailing address

11921 S DIXIE HWY STE 215
PINECREST FL
33156-4449
US

V. Phone/Fax

Practice location:
  • Phone: 786-718-3890
  • Fax: 305-238-3511
Mailing address:
  • Phone: 786-718-3890
  • Fax: 305-238-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 11013
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 8496
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 10727
License Number StateFL

VIII. Authorized Official

Name: MAYALY ALVAREZ
Title or Position: MANAGER
Credential: MENTAL HEALTH
Phone: 305-662-1095