Provider Demographics
NPI:1689952475
Name:ST. FLEUR, MARIE (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:ST. FLEUR
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6032 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4613
Mailing Address - Country:US
Mailing Address - Phone:786-985-5129
Mailing Address - Fax:
Practice Address - Street 1:7463 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2216
Practice Address - Country:US
Practice Address - Phone:754-307-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5459OtherIMHC