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General NPI Number Information
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NPI Number | 1639796675
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Entity Type | Organization
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Legal Business Name | SEASONS PSYCHOTHERAPY ASSOCIATES LLC
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 12505 ORANGE DR STE 901
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City | DAVIE
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State | FL
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Zip | 33330-4300
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Country | US
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Telephone | 954-342-0982
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Fax | 954-342-1080
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Provider Business Mailing Address
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Address Line | 2601 E OAKLAND PARK BLVD STE 205
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1658
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Country | US
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Telephone | 954-342-0982
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Fax | 954-342-1080
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Authorized Official
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Title or Position | CEO
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Name | CAROL MIRONES
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Credential | LCSW, LMFT
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Telephone | 855-949-5310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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