Provider Demographics
NPI:1902228141
Name:2000 THERAPY CENTER
Entity Type:Organization
Organization Name:2000 THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ODALYS
Authorized Official - Middle Name:J
Authorized Official - Last Name:WAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-491-5223
Mailing Address - Street 1:12651 S DIXIE HWY
Mailing Address - Street 2:SUITE 317
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5975
Mailing Address - Country:US
Mailing Address - Phone:305-491-5223
Mailing Address - Fax:
Practice Address - Street 1:12651 S DIXIE HWY
Practice Address - Street 2:SUITE 317
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5975
Practice Address - Country:US
Practice Address - Phone:305-491-5223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8795101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty