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General NPI Number Information
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NPI Number | 1306589775
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Entity Type | Organization
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Legal Business Name | MERAKI LIFE COUNSELING, LLC
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 2719 HOLLYWOOD BLVD STE A-1979
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4821
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Country | US
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Telephone | 754-837-7827
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 N UNIVERSITY DR UNIT 840332
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City | PEMBROKE PINES
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State | FL
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Zip | 33084-4074
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER WILLIAMS
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Credential | LMHC
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Telephone | 754-837-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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