Healthcare Provider Details

I. General information

NPI: 1154192003
Provider Name (Legal Business Name): SHIELDMEE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 NW FORK RD
STUART FL
34994-8905
US

IV. Provider business mailing address

842 NW FORK RD
STUART FL
34994-8905
US

V. Phone/Fax

Practice location:
  • Phone: 786-972-1073
  • Fax:
Mailing address:
  • Phone: 786-972-1073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO ENRIQUE FLOREZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMHC
Phone: 786-972-1073