MEDICARE: MS. CAROLINA WELSH MS

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	9553	FL

General Provider Information

NPI Number	:	1962652792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROLINA WELSH MS

Provider Business Mailing Address
First Line	:	770 CLAUGHTON ISLAND DR
Second Line	:	APT 1710
City	:	MIAMI
State	:	FL
Zip	:	33131-2617
Country	:	US
Telephone Number	:	305-491-6129
Fax Number	:

Provider Business Practice Location Address
First Line	:	1909 TYLER ST
Second Line	:	SUITE 504
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4527
Country	:	US
Telephone Number	:	954-929-7515
Fax Number	:

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

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	09/29/2008

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