Provider Demographics
NPI:1285659011
Name:MINKIN, CAROL H (MA)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:H
Last Name:MINKIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:HALPERIN
Other - Last Name:MINKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:4405 WOODFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4405 WOODFIELD BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5303
Practice Address - Country:US
Practice Address - Phone:561-279-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5065101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health