Provider Demographics
NPI:1417392119
Name:MIAMI COUNSELING CENTER
Entity Type:Organization
Organization Name:MIAMI COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PUIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-218-1894
Mailing Address - Street 1:11401 SW 40 ST
Mailing Address - Street 2:STE#307
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33163
Mailing Address - Country:US
Mailing Address - Phone:305-227-9100
Mailing Address - Fax:
Practice Address - Street 1:11401 SW 40 ST
Practice Address - Street 2:STE#308
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33163
Practice Address - Country:US
Practice Address - Phone:305-227-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty