=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063019909
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SADE DEBRA LAW MA, LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2020
-----------------------------------------------------
Last Update Date | 08/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1041 BELLAMY RD
-----------------------------------------------------
City | MELROSE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32666-3152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-448-5733
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 80 SW 8TH ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33130-3003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-374-5600
-----------------------------------------------------
Fax | 833-419-0181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MT4945
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------