Provider Demographics
NPI:1235380882
Name:HUYSMAN, JAMES (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:HUYSMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4158
Mailing Address - Country:US
Mailing Address - Phone:305-571-9996
Mailing Address - Fax:305-571-9506
Practice Address - Street 1:3050 BISCAYNE BLVD
Practice Address - Street 2:SUITE 605
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4158
Practice Address - Country:US
Practice Address - Phone:305-571-9996
Practice Address - Fax:305-571-9506
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW32271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7764AMedicare PIN