Provider Demographics
NPI:1336204783
Name:ANXIETY & STRESS MANAGEMENT CENTER
Entity type:Organization
Organization Name:ANXIETY & STRESS MANAGEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:O
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-279-1715
Mailing Address - Street 1:9135 S.W. 125 AVE
Mailing Address - Street 2:STE #P203
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186
Mailing Address - Country:US
Mailing Address - Phone:305-279-1715
Mailing Address - Fax:305-279-1715
Practice Address - Street 1:8525 SW 92 STREET
Practice Address - Street 2:STE A3
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7374
Practice Address - Country:US
Practice Address - Phone:305-279-1715
Practice Address - Fax:305-279-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW1381103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1638Medicare ID - Type Unspecified