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General NPI Number Information
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NPI Number | 1831643584
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Entity Type | Organization
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Legal Business Name | MCH COUNSELING LLC
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 2400 N UNIVERSITY DR STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3629
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Country | US
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Telephone | 305-741-3670
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Fax |
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Provider Business Mailing Address
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Address Line | 15757 PINES BLVD # 246
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1207
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MAURIANNA SWANSON
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Credential | MS, LMHC
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Telephone | 305-741-3670
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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 | MH10867
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License Number State | FL
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