Provider Demographics
NPI:1275103954
Name:ADAY, ERIC J (MH19222)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:J
Last Name:ADAY
Suffix:
Gender:M
Credentials:MH19222
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3825
Mailing Address - Country:US
Mailing Address - Phone:786-200-7911
Mailing Address - Fax:
Practice Address - Street 1:9198 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2004
Practice Address - Country:US
Practice Address - Phone:786-484-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH19222OtherLICENSED MENTAL HEALTH COUNSELOR