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General NPI Number Information
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NPI Number | 1770836074
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Entity Type | Individual
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Provider Name | ERIC SEBASTIAN TROY LMHC
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Gender | Male
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Dates
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Enumeration Date | 10/24/2012
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 18999 BISCAYNE BLVD SUITE 200
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City | AVENTURA
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State | FL
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Zip | 33180-2814
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Country | US
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Telephone | 786-315-3483
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Fax |
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Provider Business Mailing Address
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Address Line | 18999 BISCAYNE BLVD STE 200
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City | AVENTURA
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State | FL
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Zip | 33180-2814
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Country | US
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Telephone | 305-200-6191
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Fax |
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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 11564
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License Number State | FL
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