Provider Demographics
NPI:1215536180
Name:M.A.M. THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:M.A.M. THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERROA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-934-4382
Mailing Address - Street 1:20535 NW 2ND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2547
Mailing Address - Country:US
Mailing Address - Phone:305-934-4382
Mailing Address - Fax:305-437-7675
Practice Address - Street 1:20535 NW 2ND AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-2547
Practice Address - Country:US
Practice Address - Phone:786-529-6486
Practice Address - Fax:305-437-7675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty