| Senior Living Memory Health, Inc. | |
|
16853 Ne 2nd Ave Ste 304 North Miami Beach FL 33162-1776 | |
| (786) 414-6666 | |
| (786) 221-3542 |
| Full Name | Senior Living Memory Health, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 16853 Ne 2nd Ave Ste 304, North Miami Beach, Florida |
| Authorized Official Name and Position | Elizabeth Bicknell (PRESIDENT) |
| Authorized Official Contact | 9544085411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Living Memory Health, Inc. 16853 Ne 2nd Ave Ste 304 North Miami Beach FL 33162-1776 Ph: (786) 414-6666 | Senior Living Memory Health, Inc. 16853 Ne 2nd Ave Ste 304 North Miami Beach FL 33162-1776 Ph: (786) 414-6666 |
| NPI Number | 1851847834 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 02/26/2025 |
| Certification Date | 02/26/2025 |
| Medicare PECOS PAC ID | 7517480577 |
|---|---|
| Medicare Enrollment ID | O20250331001923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851847834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY5534 (Florida) | Primary |
| Provider Name | Mary Hearn Warren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205872892 PECOS PAC ID: 5294754834 Enrollment ID: I20051114000470 |
| Provider Name | Edward M Baron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679672307 PECOS PAC ID: 2769561471 Enrollment ID: I20080507000085 |
| Provider Name | Elizabeth Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407007859 PECOS PAC ID: 0244390417 Enrollment ID: I20081118000180 |
| Provider Name | Omayra Lizardo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023301298 PECOS PAC ID: 7719159615 Enrollment ID: I20111019000767 |
| Provider Name | Carmen Luisa Galano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669660064 PECOS PAC ID: 6901030857 Enrollment ID: I20131014000237 |
| Provider Name | Jonathan R Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144521501 PECOS PAC ID: 0749464998 Enrollment ID: I20131015000285 |
| Provider Name | Elizabeth Syder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194147272 PECOS PAC ID: 6103056684 Enrollment ID: I20140228001246 |
| Provider Name | Mary B Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124351473 PECOS PAC ID: 5698075760 Enrollment ID: I20151120001348 |
| Provider Name | Kristen Midgette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326523747 PECOS PAC ID: 9931518826 Enrollment ID: I20210505001650 |
| Provider Name | Rebecca R Jaggernauth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124391313 PECOS PAC ID: 1052714110 Enrollment ID: I20210727001880 |
| Provider Name | Sharon Mcdaniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144729427 PECOS PAC ID: 0143624759 Enrollment ID: I20210804001550 |
| Provider Name | Alisa Katims |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891047874 PECOS PAC ID: 0749685402 Enrollment ID: I20210819000559 |
| Provider Name | Ryan Laben |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568121259 PECOS PAC ID: 5496142028 Enrollment ID: I20220428000977 |
| Provider Name | Kathleen M Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518909498 PECOS PAC ID: 0345203246 Enrollment ID: I20220713001618 |
| Provider Name | Stephanier Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053046672 PECOS PAC ID: 1759766538 Enrollment ID: I20220914002679 |
| Provider Name | Theresa Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295266674 PECOS PAC ID: 5294110011 Enrollment ID: I20220915000390 |
| Provider Name | Elaina Konsoulas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659093300 PECOS PAC ID: 0749666451 Enrollment ID: I20221004001978 |
| Provider Name | Nancy Mendoza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659743169 PECOS PAC ID: 3072999549 Enrollment ID: I20221006001800 |
| Provider Name | Emily Kleyman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992738041 PECOS PAC ID: 3678635836 Enrollment ID: I20230116000665 |
| Provider Name | Emmanuela Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033525399 PECOS PAC ID: 8123493764 Enrollment ID: I20230412001580 |
| Provider Name | Dora Zaitman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376084939 PECOS PAC ID: 5698130466 Enrollment ID: I20230501000420 |
| Provider Name | Mamie Lumpkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003177866 PECOS PAC ID: 2860848017 Enrollment ID: I20231025001230 |
| Provider Name | Rosciara Pugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013315134 PECOS PAC ID: 5698127280 Enrollment ID: I20240119000115 |
| Provider Name | Roselyn Medina |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659629020 PECOS PAC ID: 1254783855 Enrollment ID: I20240119000393 |
| Provider Name | Sheilla Brunelus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568990109 PECOS PAC ID: 2769834282 Enrollment ID: I20240122000091 |
| Provider Name | Avery May |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447926076 PECOS PAC ID: 2466804885 Enrollment ID: I20240122000507 |
| Provider Name | Gerald Button |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073630729 PECOS PAC ID: 3577915917 Enrollment ID: I20240122001191 |
| Provider Name | Nilda De La Fe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265605976 PECOS PAC ID: 7517319858 Enrollment ID: I20240123000293 |
| Provider Name | Sara Gorman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386275451 PECOS PAC ID: 8820432743 Enrollment ID: I20240220000994 |
| Provider Name | Stephanie Kuczinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558053512 PECOS PAC ID: 3779927637 Enrollment ID: I20240220001025 |
| Provider Name | Ramon S Orin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104107093 PECOS PAC ID: 4981049400 Enrollment ID: I20240223003279 |
| Provider Name | Brianna Mcmaster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730637018 PECOS PAC ID: 1951777564 Enrollment ID: I20240314004264 |
| Provider Name | Kyle Short |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073199048 PECOS PAC ID: 4082056189 Enrollment ID: I20240521001953 |
| Provider Name | Haylee Corrales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639260284 PECOS PAC ID: 0244772267 Enrollment ID: I20240606000027 |
| Provider Name | Vanessa Renfort |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457005829 PECOS PAC ID: 6901349406 Enrollment ID: I20240625000277 |
| Provider Name | Fiona Osborne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558756346 PECOS PAC ID: 1153867411 Enrollment ID: I20240723000932 |
| Provider Name | Josiane Menos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346546801 PECOS PAC ID: 2365988417 Enrollment ID: I20240724003969 |
| Provider Name | Roxann Murrell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053822015 PECOS PAC ID: 9234675307 Enrollment ID: I20240725000205 |
| Provider Name | Shannon Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184464406 PECOS PAC ID: 7719423649 Enrollment ID: I20240726001975 |
| Provider Name | Eliana Orozco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841537974 PECOS PAC ID: 1951840420 Enrollment ID: I20240828002196 |
| Provider Name | Therese Colette Latorre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447428859 PECOS PAC ID: 0042692667 Enrollment ID: I20241011003113 |
| Provider Name | Rebecca Harter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528706843 PECOS PAC ID: 0446782577 Enrollment ID: I20241015001004 |
| Provider Name | Anastasia Sabga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134993751 PECOS PAC ID: 2163954132 Enrollment ID: I20241015002965 |
| Provider Name | Lashaune Mccottry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306289095 PECOS PAC ID: 3779015680 Enrollment ID: I20241016004694 |
| Provider Name | Bambi Fanto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972938488 PECOS PAC ID: 6901338813 Enrollment ID: I20241016004934 |
| Provider Name | Edith Garzon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881392397 PECOS PAC ID: 1355873266 Enrollment ID: I20241016004957 |
| Provider Name | Andrea Nowakowski |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871939702 PECOS PAC ID: 1254863756 Enrollment ID: I20241021004487 |
| Provider Name | Brianna Loli |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104646769 PECOS PAC ID: 4789118829 Enrollment ID: I20241112000849 |
| Provider Name | Gilda Clarke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124390992 PECOS PAC ID: 5991239089 Enrollment ID: I20241112003017 |
| Provider Name | Gislene Schurman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396173712 PECOS PAC ID: 4880123017 Enrollment ID: I20250131003321 |
| Provider Name | Tamara Pierre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093235988 PECOS PAC ID: 0749710838 Enrollment ID: I20250204003294 |
| Provider Name | Silvia Mcbride |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255097861 PECOS PAC ID: 2860922903 Enrollment ID: I20250205000974 |
| Provider Name | Huggyse Armand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801396312 PECOS PAC ID: 1850821547 Enrollment ID: I20250211001016 |
| Provider Name | Michelle L Manders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225419534 PECOS PAC ID: 9739609991 Enrollment ID: I20250219001146 |
| Provider Name | Madeline Main |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902371438 PECOS PAC ID: 7416477112 Enrollment ID: I20250225002578 |
| Provider Name | Teresa Diane Dore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184764847 PECOS PAC ID: 0446770879 Enrollment ID: I20250227003922 |
| Provider Name | Darlene Denise Rolle- Cargill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497365456 PECOS PAC ID: 8921521527 Enrollment ID: I20250325000036 |
| Provider Name | Rafael Guzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699053140 PECOS PAC ID: 1658894761 Enrollment ID: I20250331000537 |
| Provider Name | Carmen Franco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578363032 PECOS PAC ID: 7911423520 Enrollment ID: I20250428001213 |
| Provider Name | Shelly R Goodson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619787116 PECOS PAC ID: 6204354137 Enrollment ID: I20250515000077 |
| Provider Name | Jessie J Alfin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629410915 PECOS PAC ID: 4385163112 Enrollment ID: I20250526000178 |
| Provider Name | Nadine Finger-thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043010804 PECOS PAC ID: 9830608611 Enrollment ID: I20250603002047 |
| Provider Name | Alexandra Seidman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770291551 PECOS PAC ID: 0244740629 Enrollment ID: I20250605003986 |
| Provider Name | Eliana M Reyes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609666569 PECOS PAC ID: 1759891534 Enrollment ID: I20250610003538 |
| Provider Name | Michelle Kabryn Pavlovich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336807353 PECOS PAC ID: 9537555339 Enrollment ID: I20250611000022 |
| Provider Name | Lucy E Richards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588912125 PECOS PAC ID: 4385154012 Enrollment ID: I20250611000841 |
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