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General NPI Number Information
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NPI Number | 1487468948
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Entity Type | Organization
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Legal Business Name | MVG MENTAL HEALTH & WELLNESS
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 8910 MIRAMAR PKWY
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City | MIRAMAR
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State | FL
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Zip | 33025-4100
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Country | US
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Telephone | 954-793-1125
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Fax |
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Provider Business Mailing Address
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Address Line | 8910 MIRAMAR PKWY STE 305 B PMB1036
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City | MIRAMAR
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State | FL
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Zip | 33025-4100
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Country | US
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Telephone | 954-793-1125
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RASHIDA GORDON
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Credential | LMHC
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Telephone | 954-793-1125
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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 |
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License Number State |
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Taxonomy #2
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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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