Provider Demographics
NPI:1275811762
Name:ALPHONSE, DILETTE (LMHC, CAP)
Entity Type:Individual
Prefix:MRS
First Name:DILETTE
Middle Name:
Last Name:ALPHONSE
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 N. 29TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020
Mailing Address - Country:US
Mailing Address - Phone:954-965-6408
Mailing Address - Fax:954-965-6444
Practice Address - Street 1:3400 N. 29TH AVENUE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020
Practice Address - Country:US
Practice Address - Phone:954-965-6408
Practice Address - Fax:954-965-6444
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH6085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health