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General NPI Number Information
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NPI Number | 1053645606
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Entity Type | Individual
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Provider Name | LAURIE MICHAEL BERMAN LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 1860 N PINE ISLAND RD
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City | PLANTATION
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State | FL
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Zip | 33322-5239
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Country | US
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Telephone | 954-629-3273
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Fax |
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Provider Business Mailing Address
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Address Line | 9631 NW 11TH STREET
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City | PLANTATION
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State | FL
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Zip | 33322
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Country | US
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Telephone | 954-472-7626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH002989
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License Number State | FL
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