Provider Demographics
NPI:1285910265
Name:BATISTA, MAYLIN (PHD,LMHC,CCS)
Entity type:Individual
Prefix:DR
First Name:MAYLIN
Middle Name:
Last Name:BATISTA
Suffix:
Gender:F
Credentials:PHD,LMHC,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15476 NW 77TH CT
Mailing Address - Street 2:SUITE 131
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5823
Mailing Address - Country:US
Mailing Address - Phone:786-423-4612
Mailing Address - Fax:
Practice Address - Street 1:6001 NW 153RD ST
Practice Address - Street 2:SUITE 157
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2419
Practice Address - Country:US
Practice Address - Phone:786-423-4612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-23
Last Update Date:2018-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10092103K00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst