MEDICARE: AMY EXUM LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH15865	FL

General Provider Information

NPI Number	:	1043700511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY EXUM LMHC

Provider Business Mailing Address
First Line	:	6900 SW 80TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-4931
Country	:	US
Telephone Number	:	786-662-8901
Fax Number	:	786-662-4649

Provider Business Practice Location Address
First Line	:	6900 SW 80TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-4931
Country	:	US
Telephone Number	:	786-662-8901
Fax Number	:	786-662-4649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2018
Last Update Date	:	05/10/2018

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