Provider Demographics
NPI:1710370788
Name:MANSO GARATEIX, ALEXANDER (LMHC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:MANSO GARATEIX
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2456 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2002
Mailing Address - Country:US
Mailing Address - Phone:703-501-5752
Mailing Address - Fax:
Practice Address - Street 1:2456 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2002
Practice Address - Country:US
Practice Address - Phone:703-501-5752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMH1278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health