Provider Demographics
NPI:1184372534
Name:PLANAS, IVELISSE M (IMHC)
Entity type:Individual
Prefix:
First Name:IVELISSE
Middle Name:M
Last Name:PLANAS
Suffix:
Gender:F
Credentials:IMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 SW 115TH AVE APT G6
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1067
Mailing Address - Country:US
Mailing Address - Phone:787-429-1314
Mailing Address - Fax:
Practice Address - Street 1:2264 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3112
Practice Address - Country:US
Practice Address - Phone:305-631-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health