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General NPI Number Information
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NPI Number | 1386879773
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Entity Type | Individual
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Provider Name | SUSANA MONTALVO LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 4175 W 20TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-5874
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Country | US
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Telephone | 305-817-1177
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Fax | 786-209-2030
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Provider Business Mailing Address
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Address Line | 12864 SW 53RD ST
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City | MIAMI
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State | FL
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Zip | 33175-5416
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Country | US
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Telephone | 305-225-7879
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Fax | 305-820-8980
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 5761
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License Number State | FL
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