Provider Demographics
NPI:1437580792
Name:ACCESS MENTAL SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:ACCESS MENTAL SOLUTIONS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA DE PORTO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-401-7818
Mailing Address - Street 1:42 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4842
Mailing Address - Country:US
Mailing Address - Phone:786-401-7818
Mailing Address - Fax:786-431-1065
Practice Address - Street 1:42 E 5TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4842
Practice Address - Country:US
Practice Address - Phone:786-401-7818
Practice Address - Fax:786-431-1065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10659101YM0800X
FLHCC10378251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004073400Medicaid
FL010521200Medicaid