Provider Demographics
NPI:1609278258
Name:SAOUD, SAMIRA DA SILVA (RMHCI)
Entity Type:Individual
Prefix:
First Name:SAMIRA
Middle Name:DA SILVA
Last Name:SAOUD
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2267 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8532
Mailing Address - Country:US
Mailing Address - Phone:407-497-1615
Mailing Address - Fax:
Practice Address - Street 1:2267 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8532
Practice Address - Country:US
Practice Address - Phone:407-497-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10961101YS0200X
IMH10961101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10961OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH