MENTAL WELLNESS CLINIC, LLC (NPI# 1336622489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336622489 |
| Entity Type | Organization |
| Organization Name | MENTAL WELLNESS CLINIC, LLC |
| Practice Address |
3580 Mystic Pointe Dr Aventura FL 33180-2554 |
| Mailing Address |
309 S 57th Ter Hollywood FL 33023-1426 |
| Practice Telephone | 7867087166 |
| Mailing Telephone | 3053384027 |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |
| Authorized Official Name | NICOLE BERRY (CEO) |
| Authorized Official Telephone | 3053384027 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
3580 MYSTIC POINTE DR |
| City | AVENTURA |
| State | FL |
| Zip Code | 33180-2554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215264536 | Reynaldo Lopez | Internal Medicine | 3580 Mystic Pointe Dr, Aventura, FL 33180-2554 | 2009-11-06 |
| 1063025583 | Rodna Francois | Counselor | 3580 Mystic Pointe Dr, Aventura, FL 33180-2554 | 2020-08-25 |
| 1861059768 | Lopezmd | Internal Medicine | 3580 Mystic Pointe Dr, Aventura, FL 33180-2554 | 2019-05-26 |
| 1821575655 | Lighthouse Wellness & Vitality | Counselor | 3580 Mystic Pointe Dr, Aventura, FL 33180-2554 | 2018-07-24 |
| 1598242851 | Vanessa Arango | Counselor | 3580 Mystic Pointe Dr, Aventura, FL 33180-2554 | 2018-07-19 |
| 1912405614 | Your Space Wellness and Consulting LLC | Point of Service | 3580 Mystic Pointe Dr, Aventura, FL 33180-2554 | 2018-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607849 | Nabeel Rahman Khan | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Boulevard, Avetura, Fl, Aventura, FL 33180 | 2020-04-09 |
| 1235766841 | Hanny Hausmann | Counselor | 2999 Ne 191 Street, Suite 902, Aventura, FL 33180 | 2020-03-24 |
| 1760976369 | Michael Ernest Molino | Optometrist | 19575 Biscayne Blvd Ste 579, Aventura, FL 33180 | 2018-06-18 |
| 1932602620 | Carmen Somarriba | Physician Assistant | 21110 Biscayne Blvd Bldg Suite400, Aventura, FL 33180 | 2018-03-09 |
| 1235631474 | Premier Florida Podiatry, Pa | Podiatrist | 3060 Ne 190th St Apt 202, Aventura, FL 33180 | 2018-03-04 |
| 1891229126 | Ifrah Zahid Butt | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd., Aventura, FL 33180 | 2017-04-13 |
| 1629500129 | Hector Hugo Gonzalez | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd, South Tower, #807, Aventura Hospital and Medical Center, Aventura, FL 33180 | 2017-04-03 |
| 1457892671 | Nusen Beer | Internal Medicine | 20200 W Dixie Hwy Ste 701, Aventura, FL 33180 | 2017-03-20 |
| 1073052338 | Alfa Diagnostic LLC | Point of Service | 21355 E Dixie Hwy Ste 101, Aventura, FL 33180 | 2017-02-20 |
| 1598211740 | Katherine Mendez-martinez | Nurse Practitioner | 2925 Aventura Blvd. Suite 101, Aventura, FL 33180 | 2016-08-28 |
| Find all providers in zip 33180 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235766841 | Hanny Hausmann | Counselor | 2999 Ne 191 Street, Suite 902, Aventura, FL 33180 | 2020-03-24 |
| 1346601135 | Noga Behar | Counselor | 3401 N Country Club Dr, 811, Aventura, FL 33180-1700 | 2016-03-08 |
| 1194111591 | Thalia Reitkopf Lmhc, Pa | Counselor | 17501 Biscayne Blvd, Suite 450, Aventura, FL 33160-4802 | 2015-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588322 | Rebecca Ann Heald | Counselor | 2430 Duncan Dr, Niceville, FL 32578-2916 | 2020-11-02 |
| 1598366171 | Neurodiverse Ability Services LLC | Counselor | 608 Sw Marvin Burnett Rd, Lake City, FL 32025-4918 | 2020-11-02 |
| 1316547839 | Amber Kovach | Counselor | 8290 Matisse St, Champions Gate, FL 33896-8334 | 2020-10-26 |
| 1760081202 | Nih Holdings LLC | Counselor | 7711 N Military Trl Ste 1014, West Palm Beach, FL 33410-6506 | 2020-10-24 |
| 1346849072 | Blanca Rodriguez | Counselor | 1201 Lavender Jewel Ct, Plant City, FL 33563-2515 | 2020-10-23 |
| 1235738063 | Selena Giordano | Counselor | 1001 East Baker Street #100, Plant City, FL 33563 | 2020-10-22 |
| 1306444989 | Robert A Fahey | Counselor | 3927 Vine Tree Trl Apt A, Lake Worth, FL 33467-8540 | 2020-10-15 |
| 1952909178 | Elizabeth Leon | Counselor | 1067 Nw 119th St, North Miami, FL 33168-6240 | 2020-10-09 |
| 1518564301 | Lisa Chhabra | Counselor | 504 Pelican Ln N, Jupiter, FL 33458-8365 | 2020-10-05 |
| 1124635081 | Always Behavioral Counseling Services | Counselor | 5724 Byron Anthony Pl Apt 338, Sanford, FL 32771-8633 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.