Provider Demographics
NPI:1205150299
Name:DEL VALLE, OSYMA (LMHC)
Entity type:Individual
Prefix:
First Name:OSYMA
Middle Name:
Last Name:DEL VALLE
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:PO BOX 2077
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33303-2077
Mailing Address - Country:US
Mailing Address - Phone:954-870-8780
Mailing Address - Fax:
Practice Address - Street 1:7811 CORAL WAY STE 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6540
Practice Address - Country:US
Practice Address - Phone:305-412-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2020-06-30
Deactivation Date:2017-12-29
Deactivation Code:
Reactivation Date:2018-07-25
Provider Licenses
StateLicense IDTaxonomies
MH8514101YM0800X, 101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH8514OtherLMHC