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General NPI Number Information
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NPI Number | 1679374243
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH GROUP PRIVATE PRACTICE PLLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 14211 SW 120TH ST # 107
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 917-592-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CHARLTON ST APT 4F
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City | NEW YORK
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State | NY
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Zip | 10014-4917
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Country | US
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Telephone | 917-592-2345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANTHONY FREIRE
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Credential | LMHC
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Telephone | 917-592-2345
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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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