Provider Demographics
NPI:1962540179
Name:SUBERVI, MILAGROS TERESA (PHD LMHC)
Entity type:Individual
Prefix:DR
First Name:MILAGROS
Middle Name:TERESA
Last Name:SUBERVI
Suffix:
Gender:F
Credentials:PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1523
Mailing Address - Country:US
Mailing Address - Phone:813-876-1832
Mailing Address - Fax:813-876-0133
Practice Address - Street 1:201 N MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1523
Practice Address - Country:US
Practice Address - Phone:813-876-1832
Practice Address - Fax:813-876-0133
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health