Provider Demographics
NPI:1215073986
Name:BIRD, FAITH MONICA (EDD, LMHC, CAP)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:MONICA
Last Name:BIRD
Suffix:
Gender:F
Credentials:EDD, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1876 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 200-C
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4130
Mailing Address - Country:US
Mailing Address - Phone:954-472-2377
Mailing Address - Fax:954-888-1744
Practice Address - Street 1:1876 N UNIVERSITY DR
Practice Address - Street 2:SUITE 200-C
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4130
Practice Address - Country:US
Practice Address - Phone:954-472-2377
Practice Address - Fax:954-888-1744
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 2012101YA0400X
FLMH 7548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270104313OtherTAX IDENTIFICATION NUMBER