Provider Demographics
NPI:1821247370
Name:CLARE, KAMISE TARA (MS, LMFT)
Entity type:Individual
Prefix:MS
First Name:KAMISE
Middle Name:TARA
Last Name:CLARE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16332 SW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4692
Mailing Address - Country:US
Mailing Address - Phone:305-632-6771
Mailing Address - Fax:
Practice Address - Street 1:2853 EXECUTIVE PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3656
Practice Address - Country:US
Practice Address - Phone:954-800-2686
Practice Address - Fax:954-827-6467
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4340106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist