Provider Demographics
NPI:1134370869
Name:THELUSMA, EDLYNE (LMHC)
Entity type:Individual
Prefix:
First Name:EDLYNE
Middle Name:
Last Name:THELUSMA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 MIRAMAR PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3972
Mailing Address - Country:US
Mailing Address - Phone:305-814-3437
Mailing Address - Fax:
Practice Address - Street 1:6151 MIRAMAR PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3972
Practice Address - Country:US
Practice Address - Phone:305-814-3437
Practice Address - Fax:954-252-4492
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12577101YM0800X
FLIMH6494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health