Provider Demographics
NPI:1952076622
Name:DELGADO, MAILIN (EDS, LMHC)
Entity Type:Individual
Prefix:
First Name:MAILIN
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:EDS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 NE 183RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4612
Mailing Address - Country:US
Mailing Address - Phone:786-487-2004
Mailing Address - Fax:
Practice Address - Street 1:3580 MYSTIC POINTE DR
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2554
Practice Address - Country:US
Practice Address - Phone:786-702-4383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1539103TS0200X
FLMH18544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool