MEDICARE: MS. NATASHA NESIC MA., RMHCI, AT

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	101Y00000X	Counselor	IMH15880	FL
2	221700000X	Art Therapist	18-022	FL
3	101YM0800X	Mental Health Counselor	MH18239	FL

General Provider Information

NPI Number	:	1548701428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATASHA NESIC MA., RMHCI, AT

Provider Business Mailing Address
First Line	:	100 BAYVIEW DR APT 1528
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-5326
Country	:	US
Telephone Number	:	786-333-9097
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 BAYVIEW DR APT 1528
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-5326
Country	:	US
Telephone Number	:	786-333-9097
Fax Number	:

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

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	03/08/2021

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