Provider Demographics
NPI:1194524066
Name:CERELIGHT MENTAL HEALTH
Entity type:Organization
Organization Name:CERELIGHT MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DPN
Authorized Official - Phone:305-709-1950
Mailing Address - Street 1:8785 SW 165TH AVE STE 200-2010
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5826
Mailing Address - Country:US
Mailing Address - Phone:305-709-1950
Mailing Address - Fax:
Practice Address - Street 1:8785 SW 165TH AVE STE 200-2010
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5826
Practice Address - Country:US
Practice Address - Phone:305-709-1950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty