Provider Demographics
NPI:1083143689
Name:ME TIME HEALING LLC
Entity Type:Organization
Organization Name:ME TIME HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C0-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELE
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:TREVATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, QS, MCAP, ICAD
Authorized Official - Phone:561-463-2073
Mailing Address - Street 1:842 SW 9TH STREET CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-5215
Mailing Address - Country:US
Mailing Address - Phone:561-866-8794
Mailing Address - Fax:
Practice Address - Street 1:1600 S DIXIE HWY STE 508
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7454
Practice Address - Country:US
Practice Address - Phone:561-463-2073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X
FLMH1226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty