Provider Demographics
NPI:1962062083
Name:ATICK, MERY F (MS, LMHC)
Entity type:Individual
Prefix:
First Name:MERY
Middle Name:F
Last Name:ATICK
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 CORAL WAY STE 4F
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3410
Mailing Address - Country:US
Mailing Address - Phone:305-998-2279
Mailing Address - Fax:
Practice Address - Street 1:2440 CORAL WAY STE 4F
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3410
Practice Address - Country:US
Practice Address - Phone:305-998-2279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty