Provider Demographics
NPI:1316191562
Name:MORETTI, CAROL J (LMHC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:MORETTI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 NE 214TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1050
Mailing Address - Country:US
Mailing Address - Phone:305-915-7873
Mailing Address - Fax:
Practice Address - Street 1:2627 NE 203RD ST
Practice Address - Street 2:SUITE 214
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1900
Practice Address - Country:US
Practice Address - Phone:305-915-7873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health