Provider Demographics
NPI:1720521388
Name:LTB INSTITUTE FOR EMPOWERMENT CHOICES, LLC.
Entity Type:Organization
Organization Name:LTB INSTITUTE FOR EMPOWERMENT CHOICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NINA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:OCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:3059-655-5777
Mailing Address - Street 1:19110 NE 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3213
Mailing Address - Country:US
Mailing Address - Phone:305-965-5777
Mailing Address - Fax:
Practice Address - Street 1:6447 MIAMI LAKES DR E STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2706
Practice Address - Country:US
Practice Address - Phone:305-965-5777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11531101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty