Provider Demographics
NPI:1134504046
Name:ROSS DE LA TORRE, YANIRA (LMHC, CBHCMS)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:ROSS DE LA TORRE
Suffix:
Gender:F
Credentials:LMHC, CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MOKENA DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6123
Mailing Address - Country:US
Mailing Address - Phone:305-922-3410
Mailing Address - Fax:
Practice Address - Street 1:280 WESTWARD DR
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-5260
Practice Address - Country:US
Practice Address - Phone:305-922-3410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLCBHCMS100491171M00000X
FLMH19536101YM0800X
FLIMH16863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111321200Medicaid
FL106861500Medicaid