Provider Demographics
NPI:1619519097
Name:MENDEZ COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:MENDEZ COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:754-216-8714
Mailing Address - Street 1:17588 SW 28TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5564
Mailing Address - Country:US
Mailing Address - Phone:754-216-8714
Mailing Address - Fax:888-886-7975
Practice Address - Street 1:1515 N UNIVERSITY DR STE 114A
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6084
Practice Address - Country:US
Practice Address - Phone:754-216-8714
Practice Address - Fax:888-886-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health