Provider Demographics
NPI:1679974869
Name:MANSON, SHLOMIT (MA, MS, LMFT)
Entity Type:Individual
Prefix:
First Name:SHLOMIT
Middle Name:
Last Name:MANSON
Suffix:
Gender:F
Credentials:MA, MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 PARKVIEW DR
Mailing Address - Street 2:APT 2406
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2885
Mailing Address - Country:US
Mailing Address - Phone:917-902-2668
Mailing Address - Fax:212-208-2978
Practice Address - Street 1:4801 S UNIVERSITY DR
Practice Address - Street 2:SUITE 126
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3839
Practice Address - Country:US
Practice Address - Phone:917-902-2668
Practice Address - Fax:212-208-2978
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2768106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist