MEDICARE: BROWARD CENTER FOR MENTAL HEALTH, PA.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	103T00000X	Psychologist
5	103TA0400X	Addiction (Substance Use Disorder) Psychologist
6	103TB0200X	Cognitive & Behavioral Psychologist
7	103TC2200X	Clinical Child & Adolescent Psychologist
8	103TF0000X	Family Psychologist
9	103TP0016X	Prescribing (Medical) Psychologist
10	103TP2701X	Group Psychotherapy Psychologist
11	103TR0400X	Rehabilitation Psychologist
12	104100000X	Social Worker
13	1041C0700X	Clinical Social Worker
14	106H00000X	Marriage & Family Therapist
15	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1609184290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWARD CENTER FOR MENTAL HEALTH, PA.

Provider Business Mailing Address
First Line	:	3127 W HALLANDALE BEACH BLVD
Second Line	:	SUITE 115
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5150
Country	:	US
Telephone Number	:	754-816-3071
Fax Number	:	754-816-3077

Provider Business Practice Location Address
First Line	:	3127 W HALLANDALE BEACH BLVD
Second Line	:	SUITE 115
City	:	PEMBROKE PARK
State	:	FL
Zip	:	33009-5150
Country	:	US
Telephone Number	:	754-816-3071
Fax Number	:	754-816-3071

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. BARBARA IRIZARRY-LUKE
Credential	:	RN
Telephone Number	:	754-816-3071

Provider Enumeration Date	:	09/17/2010
Last Update Date	:	10/21/2011

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