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General NPI Number Information
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NPI Number | 1326705682
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Entity Type | Organization
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Legal Business Name | DIVINE LOVE & HEALING CLINICAL COUNSELING & CARE
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 1870 NW 106TH TER
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City | PLANTATION
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State | FL
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Zip | 33322-3536
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Country | US
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Telephone | 786-343-4474
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 NW 106TH TER
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City | PLANTATION
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State | FL
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Zip | 33322-3536
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Country | US
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Telephone | 786-343-4474
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. JOHN ALEXANDER PIEDRAHITA
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Credential | LMHC, LMHFT
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Telephone | 786-343-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 |
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License Number State |
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