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General NPI Number Information
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NPI Number | 1154522886
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Entity Type | Individual
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Provider Name | ELLEN E SAMIMY LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 80 SW 8TH STREET SUITE 2185
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City | MIAMI
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State | FL
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Zip | 33130
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Country | US
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Telephone | 305-965-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 614 SAN SERVANDO AVENUE
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City | CORAL GABLES
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State | FL
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Zip | 33143
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Country | US
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Telephone | 305-965-6644
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 10859
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License Number State | FL
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