Provider Demographics
NPI:1154842698
Name:METTA PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:METTA PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORNELAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-213-2727
Mailing Address - Street 1:2100 PONCE DE LEON BLVD STE 1015
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5240
Mailing Address - Country:US
Mailing Address - Phone:786-213-2727
Mailing Address - Fax:305-454-0156
Practice Address - Street 1:2100 PONCE DE LEON BLVD STE 1015
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5240
Practice Address - Country:US
Practice Address - Phone:786-213-2727
Practice Address - Fax:305-454-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherLICENSE MENTAL HEALTH COUNSELOR