Provider Demographics
NPI:1992912604
Name:INSTITUTE FOR CHILD AND FAMILY HEALTH
Entity type:Organization
Organization Name:INSTITUTE FOR CHILD AND FAMILY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MENENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-274-3172
Mailing Address - Street 1:3640 NW 9TH ST
Mailing Address - Street 2:APT. NO. 504
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3878
Mailing Address - Country:US
Mailing Address - Phone:305-213-7403
Mailing Address - Fax:
Practice Address - Street 1:9380 SW 72ND ST
Practice Address - Street 2:SUITE B-120
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3276
Practice Address - Country:US
Practice Address - Phone:305-274-3172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4682251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health