MEDICARE: EDLYNE THELUSMA 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	MH12577	FL
2	101YM0800X	Mental Health Counselor	IMH6494	FL

General Provider Information

NPI Number	:	1134370869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDLYNE THELUSMA LMHC

Provider Business Mailing Address
First Line	:	6151 MIRAMAR PKWY STE 200
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3972
Country	:	US
Telephone Number	:	305-814-3437
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 MIRAMAR PKWY STE 200
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3972
Country	:	US
Telephone Number	:	305-814-3437
Fax Number	:	954-252-4492

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

Provider Enumeration Date	:	09/30/2008
Last Update Date	:	02/12/2026

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