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General NPI Number Information
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NPI Number | 1992246698
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Entity Type | Organization
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Legal Business Name | BLUM COUNSELING GROUP
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 1125 NE 125TH ST STE 501
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5034
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Country | US
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Telephone | 305-900-7146
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Fax |
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Provider Business Mailing Address
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Address Line | 3221 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-4444
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Country | US
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Telephone | 305-900-7146
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. DEBORAH BLUM
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Credential | MFT
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Telephone | 305-900-7146
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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 | 1369
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License Number State | FL
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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 | 2471
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License Number State | FL
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