MEDICARE: MENTAL HEALTH CONSULTANTS LLC

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	MH7196	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	:	1730633884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	3991 SW GREENWOOD WAY
Second Line	:	SUITE. 3G
City	:	PALM CITY
State	:	FL
Zip	:	34990-4639
Country	:	US
Telephone Number	:	772-634-1400
Fax Number	:	772-600-8975

Provider Business Practice Location Address
First Line	:	3991 SW GREENWOOD WAY
Second Line	:	SUITE 3G
City	:	PALM CITY
State	:	FL
Zip	:	34990-4639
Country	:	US
Telephone Number	:	772-634-1400
Fax Number	:	772-600-8975

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. MARIA DELCARMEN QUINONES PEREZ
Credential	:	MH
Telephone Number	:	772-634-1400

Provider Enumeration Date	:	08/06/2016
Last Update Date	:	08/06/2016

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