Provider Demographics
NPI:1982936803
Name:CENTER FOR CHILD AND FAMILY COUNSELING,LLC
Entity Type:Organization
Organization Name:CENTER FOR CHILD AND FAMILY COUNSELING,LLC
Other - Org Name:STELLA VERNA, PHD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VERNA ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:305-254-9600
Mailing Address - Street 1:14707 S DIXIE HWY
Mailing Address - Street 2:SUITE #317
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7948
Mailing Address - Country:US
Mailing Address - Phone:305-254-9600
Mailing Address - Fax:
Practice Address - Street 1:14707 S DIXIE HWY
Practice Address - Street 2:SUITE #317
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7948
Practice Address - Country:US
Practice Address - Phone:305-254-9600
Practice Address - Fax:305-662-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5512101YM0800X
FLMH0205512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1841333978OtherNPI OF PRESIDENT STELLA VERNA, PHD