=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073252755
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABREU COUNSELING ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2022
-----------------------------------------------------
Last Update Date | 02/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11110 N KENDALL DR
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-0938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-596-3335
-----------------------------------------------------
Fax | 305-596-3976
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11110 N KENDALL DR
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33176-0938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-596-3335
-----------------------------------------------------
Fax | 305-596-3976
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED MENTAL HEALTH COUNSELOR
-----------------------------------------------------
Name | MISS AMANDA ABREU
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 786-328-3042
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------