MEDICARE: MAZZA COUNSELING & CONSULTING

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1720615800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAZZA COUNSELING & CONSULTING

Provider Business Mailing Address
First Line	:	275 MURCIA DR APT 209
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-2762
Country	:	US
Telephone Number	:	212-466-6432
Fax Number	:

Provider Business Practice Location Address
First Line	:	7136 BONITA DR APT 8
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-3067
Country	:	US
Telephone Number	:	917-843-6981
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. PAMELA MAZZA
Credential	:	LMHC
Telephone Number	:	212-466-6432

Provider Enumeration Date	:	03/26/2020
Last Update Date	:	04/14/2022

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