Provider Demographics
NPI:1316282817
Name:DUARTE, MARIA XIMENA (PSYD, LMHC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:XIMENA
Last Name:DUARTE
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 NE 141ST ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-3127
Mailing Address - Country:US
Mailing Address - Phone:305-878-4842
Mailing Address - Fax:
Practice Address - Street 1:5901 NW 183RD ST STE 310
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6008
Practice Address - Country:US
Practice Address - Phone:786-418-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16649101YM0800X
FLPY11259103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health