Provider Demographics
NPI:1114476637
Name:COUNSELING CENTER OF MIAMI
Entity type:Organization
Organization Name:COUNSELING CENTER OF MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GRETTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-269-3900
Mailing Address - Street 1:7950 W FLAGLER ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7950 W FLAGLER ST
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2206
Practice Address - Country:US
Practice Address - Phone:305-269-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8212252Y00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency