Provider Demographics
NPI:1073145686
Name:PEREIRA DA SILVA, ROSA VICTORIA (LMFT,CHT)
Entity Type:Individual
Prefix:
First Name:ROSA VICTORIA
Middle Name:
Last Name:PEREIRA DA SILVA
Suffix:
Gender:F
Credentials:LMFT,CHT
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT,CHT
Mailing Address - Street 1:17900 NW 5TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2809
Mailing Address - Country:US
Mailing Address - Phone:954-388-0800
Mailing Address - Fax:
Practice Address - Street 1:17900 NW 5TH ST STE 103
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2809
Practice Address - Country:US
Practice Address - Phone:954-388-0800
Practice Address - Fax:954-645-7755
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4670106H00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist