Provider Demographics
NPI:1518709161
Name:MIND & BODY INTEGRATIVE COUNSELING CENTER
Entity type:Organization
Organization Name:MIND & BODY INTEGRATIVE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ROSAND
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:954-281-2626
Mailing Address - Street 1:9000 SHERIDAN ST STE 154
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8801
Mailing Address - Country:US
Mailing Address - Phone:954-281-2626
Mailing Address - Fax:954-281-5946
Practice Address - Street 1:9000 SHERIDAN ST STE 154
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-8801
Practice Address - Country:US
Practice Address - Phone:954-281-2626
Practice Address - Fax:954-281-5946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty