Provider Demographics
NPI:1205063468
Name:DUROSEL, FIDJI DUROSEL (LMHC)
Entity type:Individual
Prefix:MS
First Name:FIDJI
Middle Name:DUROSEL
Last Name:DUROSEL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:FIDJI
Other - Middle Name:
Other - Last Name:ALFRED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16610 SW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3246
Mailing Address - Country:US
Mailing Address - Phone:786-493-6317
Mailing Address - Fax:
Practice Address - Street 1:16610 SW 99TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3246
Practice Address - Country:US
Practice Address - Phone:786-493-6317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLMH9251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst