Provider Demographics
NPI:1164711685
Name:MIAMI FLORIDA MENTAL HEALTH COUNSELING
Entity Type:Organization
Organization Name:MIAMI FLORIDA MENTAL HEALTH COUNSELING
Other - Org Name:MFMHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBALLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-310-4245
Mailing Address - Street 1:PO BOX 144701
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4701
Mailing Address - Country:US
Mailing Address - Phone:305-310-4245
Mailing Address - Fax:
Practice Address - Street 1:98 SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5038
Practice Address - Country:US
Practice Address - Phone:305-310-4245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty