MEDICARE: MS. TANEIKWE LAKISHA GREY-BUDHAM 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	MH7240	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245518737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TANEIKWE LAKISHA GREY-BUDHAM LMHC

Provider Business Mailing Address
First Line	:	9449 SW 18TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-4725
Country	:	US
Telephone Number	:	305-495-0375
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 W BROWARD BLVD
Second Line	:	SUITE100
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-1018
Country	:	US
Telephone Number	:	954-587-1008
Fax Number	:

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

Provider Enumeration Date	:	08/01/2011
Last Update Date	:	08/01/2011

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