Provider Demographics
NPI:1245648815
Name:HYPNOTHERAPY & COUNSELING CENTER
Entity type:Organization
Organization Name:HYPNOTHERAPY & COUNSELING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLAVIO
Authorized Official - Middle Name:BALLERINI
Authorized Official - Last Name:SOUZA-CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-8277
Mailing Address - Street 1:7360 CORAL WAY STE 23B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1482
Mailing Address - Country:US
Mailing Address - Phone:305-267-8277
Mailing Address - Fax:
Practice Address - Street 1:7360 CORAL WAY STE 23B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1482
Practice Address - Country:US
Practice Address - Phone:305-267-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty