| Unified Counseling & Mediation Pllc | |
|
7451 Riviera Blvd Ste 120 Miramar FL 33023-6569 | |
| (305) 918-2588 | |
| (305) 974-1360 |
| Full Name | Unified Counseling & Mediation Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7451 Riviera Blvd Ste 120, Miramar, Florida |
| Authorized Official Name and Position | Cassaundra Tennille Wimes (PSYCHOLOGIST) |
| Authorized Official Contact | 3059182588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Unified Counseling & Mediation Pllc 7451 Riviera Blvd Ste 120 Miramar FL 33023-6569 Ph: (305) 918-2588 | Unified Counseling & Mediation Pllc 7451 Riviera Blvd Ste 120 Miramar FL 33023-6569 Ph: (305) 918-2588 |
| NPI Number | 1932484466 |
|---|---|
| Provider Enumeration Date | 10/16/2011 |
| Last Update Date | 04/29/2023 |
| Certification Date | 04/29/2023 |
| Medicare PECOS PAC ID | 5193965846 |
|---|---|
| Medicare Enrollment ID | O20130701000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932484466 | NPI | - | NPPES |
| 013070800 | Medicaid | FL | |
| 003127500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PY 8192 (Florida) | Primary |
| Provider Name | Cassaundra T Wimes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841483062 PECOS PAC ID: 9436399185 Enrollment ID: I20130715000359 |
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