| Mind Up Advanced Counseling Services, Llc | |
|
12855 Sw 132nd St Ste 101 Miami FL 33186-7209 | |
| (305) 632-3892 | |
| Not Available |
| Full Name | Mind Up Advanced Counseling Services, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 12855 Sw 132nd St Ste 101, Miami, Florida |
| Authorized Official Name and Position | Aylem Collazo Amador (PRESIDENT) |
| Authorized Official Contact | 3056323892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Up Advanced Counseling Services, Llc 12855 Sw 132nd St Ste 101 Miami FL 33186-7209 Ph: (305) 632-3892 | Mind Up Advanced Counseling Services, Llc 12855 Sw 132nd St Ste 101 Miami FL 33186-7209 Ph: (305) 632-3892 |
| NPI Number | 1679358618 |
|---|---|
| Provider Enumeration Date | 08/28/2023 |
| Last Update Date | 09/07/2023 |
| Certification Date | 09/07/2023 |
| Medicare PECOS PAC ID | 2860844396 |
|---|---|
| Medicare Enrollment ID | O20240119001616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679358618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| Provider Name | Aylem Collazo-amador |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972832079 PECOS PAC ID: 7012369549 Enrollment ID: I20240119001840 |
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