Provider Demographics
NPI:1902403751
Name:ACEVEDO, MARIE ANNETTE (MSED, LMHC, LPC)
Entity Type:Individual
Prefix:PROF
First Name:MARIE
Middle Name:ANNETTE
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:MSED, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8918 FROUDE AVE
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3324
Mailing Address - Country:US
Mailing Address - Phone:305-699-5810
Mailing Address - Fax:
Practice Address - Street 1:8918 FROUDE AVE
Practice Address - Street 2:
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-3324
Practice Address - Country:US
Practice Address - Phone:056-995-8103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008151101YP2500X
FLMH18331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional