| Mtca Psychological Services P.a. | |
|
6067 Hollywood Blvd Ste 200 Hollywood FL 33024-7922 | |
| (786) 414-6666 | |
| (754) 888-9606 |
| Full Name | Mtca Psychological Services P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 6067 Hollywood Blvd Ste 200, Hollywood, Florida |
| Authorized Official Name and Position | Elizabeth Bicknell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7864146666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mtca Psychological Services P.a. 6067 Hollywood Blvd Ste 200 Hollywood FL 33024-7922 Ph: (786) 414-6666 | Mtca Psychological Services P.a. 6067 Hollywood Blvd Ste 200 Hollywood FL 33024-7922 Ph: (786) 414-6666 |
| NPI Number | 1740552322 |
|---|---|
| Provider Enumeration Date | 01/30/2012 |
| Last Update Date | 05/06/2021 |
| Certification Date | 05/06/2021 |
| Medicare PECOS PAC ID | 6406010834 |
|---|---|
| Medicare Enrollment ID | O20120614000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740552322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY8145 (Florida) | Primary |
| Provider Name | Carmen B Gomez-abrue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841217379 PECOS PAC ID: 7012829823 Enrollment ID: I20040528000411 |
| Provider Name | April Kassover |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972635605 PECOS PAC ID: 2062486731 Enrollment ID: I20040819001545 |
| Provider Name | Melva Colon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609070937 PECOS PAC ID: 9234195926 Enrollment ID: I20041204000010 |
| Provider Name | Nina Rothstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366528705 PECOS PAC ID: 5799730701 Enrollment ID: I20050312000080 |
| Provider Name | Bonnie E Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528174083 PECOS PAC ID: 0244272581 Enrollment ID: I20050526000042 |
| 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 | Victoria P Delissovoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639124100 PECOS PAC ID: 4789687112 Enrollment ID: I20060824000250 |
| 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 | Hedy S Cohn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306969233 PECOS PAC ID: 8729153101 Enrollment ID: I20080819000913 |
| Provider Name | Lisa Cicetti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316102114 PECOS PAC ID: 0446328512 Enrollment ID: I20081003000177 |
| Provider Name | Keiron Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538346986 PECOS PAC ID: 9234299579 Enrollment ID: I20081117000691 |
| Provider Name | Elizabeth Alexandra Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407007859 PECOS PAC ID: 0244390417 Enrollment ID: I20081118000180 |
| Provider Name | Meghan K Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457650673 PECOS PAC ID: 6103099726 Enrollment ID: I20111026000957 |
| Provider Name | Frances M Parra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407966617 PECOS PAC ID: 9537334347 Enrollment ID: I20111206000649 |
| Provider Name | Debra Lynn Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598015851 PECOS PAC ID: 4981849411 Enrollment ID: I20130403000486 |
| Provider Name | Alice Katherine Lovell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033451026 PECOS PAC ID: 2062659436 Enrollment ID: I20130503000113 |
| Provider Name | Jonathan R Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144521501 PECOS PAC ID: 0749464998 Enrollment ID: I20131015000285 |
| Provider Name | Allen S Mccormick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225035744 PECOS PAC ID: 2668692203 Enrollment ID: I20141003000450 |
| Provider Name | Kimberley Lynne Adda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932334976 PECOS PAC ID: 9335458249 Enrollment ID: I20151015001658 |
| Provider Name | Phara Lafortune-morame |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225310253 PECOS PAC ID: 6901113059 Enrollment ID: I20151112000777 |
| Provider Name | Francy N Fonseca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437517778 PECOS PAC ID: 4183920879 Enrollment ID: I20160307000601 |
| Provider Name | Claudia Ewald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184099228 PECOS PAC ID: 8820381577 Enrollment ID: I20160719000742 |
| Provider Name | Kelley Gill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083087456 PECOS PAC ID: 4981982758 Enrollment ID: I20161028001640 |
| Provider Name | Lissette Leon Iglesias |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306274865 PECOS PAC ID: 5890077374 Enrollment ID: I20170117002441 |
| Provider Name | Lauren Keysha Mason |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194033175 PECOS PAC ID: 3274818133 Enrollment ID: I20170411002724 |
| Provider Name | Rochelle Lynn Nuss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649696535 PECOS PAC ID: 7911263892 Enrollment ID: I20171108003701 |
| Provider Name | Lauren Ashley Berner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457860439 PECOS PAC ID: 5991065997 Enrollment ID: I20180213001936 |
| Provider Name | Judith Bellomo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194031567 PECOS PAC ID: 4981885407 Enrollment ID: I20180220001984 |
| Provider Name | Judith H Carney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659785947 PECOS PAC ID: 4486915691 Enrollment ID: I20180305001706 |
| Provider Name | Luz M Restrepo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023410115 PECOS PAC ID: 7719203660 Enrollment ID: I20180307001051 |
| Provider Name | Kelli A Malkasian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215471776 PECOS PAC ID: 1153685649 Enrollment ID: I20180509001984 |
| Provider Name | Andre Caruso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871002550 PECOS PAC ID: 2567719446 Enrollment ID: I20180724001142 |
| Provider Name | Patricia M Messina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316481856 PECOS PAC ID: 5092065268 Enrollment ID: I20180910001058 |
| Provider Name | Holly Goller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639661754 PECOS PAC ID: 6002153806 Enrollment ID: I20190201001672 |
| Provider Name | Rhea G Timm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043787849 PECOS PAC ID: 0840538286 Enrollment ID: I20190211002261 |
| Provider Name | Helen E Dickey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831670371 PECOS PAC ID: 0345588208 Enrollment ID: I20190219001871 |
| Provider Name | Cristnei Aquino-vado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427430461 PECOS PAC ID: 1951638592 Enrollment ID: I20190806000678 |
| Provider Name | Priya Narine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720540719 PECOS PAC ID: 0648507293 Enrollment ID: I20190806001403 |
| Provider Name | Shanique Ebanks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578937918 PECOS PAC ID: 3870820798 Enrollment ID: I20190814002991 |
| Provider Name | Janice Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083139315 PECOS PAC ID: 5496083602 Enrollment ID: I20190827000932 |
| Provider Name | Dean John Rotondo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588226575 PECOS PAC ID: 7719216191 Enrollment ID: I20190910002754 |
| Provider Name | Patricia Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992041297 PECOS PAC ID: 1456786771 Enrollment ID: I20200115000592 |
| Provider Name | Shawn C Stanton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164801304 PECOS PAC ID: 1153756887 Enrollment ID: I20200127001173 |
| Provider Name | Dagmar Nunez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952947434 PECOS PAC ID: 0941638753 Enrollment ID: I20200310000551 |
| Provider Name | Jennifer Noto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326313289 PECOS PAC ID: 6800155144 Enrollment ID: I20200416001239 |
| Provider Name | Brittney Eluett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396351821 PECOS PAC ID: 1658782354 Enrollment ID: I20201202000886 |
| Provider Name | Elizabeth A Gingerich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184246456 PECOS PAC ID: 1658783048 Enrollment ID: I20201208002694 |
| Provider Name | Amanda Werdann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386230555 PECOS PAC ID: 7315350394 Enrollment ID: I20210112002363 |
| Provider Name | Katrina Forman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447538269 PECOS PAC ID: 1658785233 Enrollment ID: I20210121001896 |
| Provider Name | Pamela Dahlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902492770 PECOS PAC ID: 3375957426 Enrollment ID: I20210201000693 |
| Provider Name | Lamercie Desir |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386290351 PECOS PAC ID: 6204240260 Enrollment ID: I20210202002904 |
| Provider Name | Miranda Ann Herbert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124540570 PECOS PAC ID: 4688080153 Enrollment ID: I20210308001814 |
| Provider Name | Christina Brumer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275123697 PECOS PAC ID: 9830507508 Enrollment ID: I20210419000251 |
| Provider Name | Kristen Midgette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326523747 PECOS PAC ID: 9931518826 Enrollment ID: I20210505001650 |
| Provider Name | Michelle L Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215560354 PECOS PAC ID: 2466851092 Enrollment ID: I20210601002078 |
| Provider Name | Selma Rodriguez Freijo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952984213 PECOS PAC ID: 2567861917 Enrollment ID: I20210604001205 |
| Provider Name | Tyauna Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588252084 PECOS PAC ID: 0648670695 Enrollment ID: I20210611001814 |
| Provider Name | Marcus M Flanagan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174721401 PECOS PAC ID: 2769884758 Enrollment ID: I20210713003832 |
| Provider Name | Sharon Mcdaniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144729427 PECOS PAC ID: 0143624759 Enrollment ID: I20210804001550 |
| Provider Name | Skyler Makkinje |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851961734 PECOS PAC ID: 9032514898 Enrollment ID: I20210818000254 |
| Provider Name | Alisa Katims |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891047874 PECOS PAC ID: 0749685402 Enrollment ID: I20210819000559 |
| Provider Name | Diana Zarayasi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477163178 PECOS PAC ID: 3375948466 Enrollment ID: I20210827001929 |
| Provider Name | Melissa Gart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639842461 PECOS PAC ID: 8224434063 Enrollment ID: I20210902002040 |
| Provider Name | Kala Markeena Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609248681 PECOS PAC ID: 5698171130 Enrollment ID: I20210908001695 |
| Provider Name | Olivia Pierre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700555067 PECOS PAC ID: 3870991516 Enrollment ID: I20211009000093 |
| Provider Name | Elizabeth L. Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043702418 PECOS PAC ID: 8325393259 Enrollment ID: I20211015000621 |
| Provider Name | Nicole Renee Ovedia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700454105 PECOS PAC ID: 0840688776 Enrollment ID: I20211026003630 |
| Provider Name | Fabiola Audibert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376919860 PECOS PAC ID: 2567852742 Enrollment ID: I20211201003180 |
| Provider Name | Beth Stewart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013037217 PECOS PAC ID: 2365832482 Enrollment ID: I20211204000216 |
| Provider Name | Noeline Coore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235513680 PECOS PAC ID: 2769874304 Enrollment ID: I20220111002898 |
| Provider Name | Marsha A. Kerr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245544477 PECOS PAC ID: 7618369091 Enrollment ID: I20220114000729 |
| Provider Name | Adam Psyd Shemony |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336809904 PECOS PAC ID: 7911394911 Enrollment ID: I20220421000768 |
| Provider Name | Cynthia Canales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174285522 PECOS PAC ID: 0244627982 Enrollment ID: I20220427000345 |
| Provider Name | Katrina Verdon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588325856 PECOS PAC ID: 7719374487 Enrollment ID: I20220427001568 |
| Provider Name | Steven Agelidis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861964819 PECOS PAC ID: 3577950963 Enrollment ID: I20220504001235 |
| Provider Name | Besima Halilovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932841269 PECOS PAC ID: 8628455144 Enrollment ID: I20220520002410 |
| Provider Name | John Betancourt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225564982 PECOS PAC ID: 1557749660 Enrollment ID: I20220601003042 |
| Provider Name | Diana Ferro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700548138 PECOS PAC ID: 2769862416 Enrollment ID: I20220712001230 |
| Provider Name | Danielle N Greene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003548785 PECOS PAC ID: 0345620001 Enrollment ID: I20220712001915 |
| 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 | Deidre Ann Ricketts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649764663 PECOS PAC ID: 0143602821 Enrollment ID: I20220727001951 |
| Provider Name | Brenda Esther Canales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598491557 PECOS PAC ID: 6305229170 Enrollment ID: I20220811003840 |
| Provider Name | Igor Belokon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275127813 PECOS PAC ID: 4284017955 Enrollment ID: I20220812000486 |
| Provider Name | Thais Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497220354 PECOS PAC ID: 7315320967 Enrollment ID: I20220816000425 |
| Provider Name | Paviella Ruether |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356530695 PECOS PAC ID: 0446635387 Enrollment ID: I20220914000402 |
| 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 | Charly Mathew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447470927 PECOS PAC ID: 2769863729 Enrollment ID: I20221007002323 |
| Provider Name | Emily Kleyman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992738041 PECOS PAC ID: 3678635836 Enrollment ID: I20230116000665 |
| Provider Name | Jennifer A Pax |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316302540 PECOS PAC ID: 8628373545 Enrollment ID: I20230123002181 |
| Provider Name | Jennifer Shafran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225747058 PECOS PAC ID: 0446622021 Enrollment ID: I20230207003717 |
| Provider Name | Nacin Fernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306567144 PECOS PAC ID: 1557737319 Enrollment ID: I20230217001505 |
| Provider Name | Steven G Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023267382 PECOS PAC ID: 4981646171 Enrollment ID: I20230421000949 |
| Provider Name | Dora Zaitman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376084939 PECOS PAC ID: 5698130466 Enrollment ID: I20230501000420 |
| Provider Name | Tiffany Glasper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508387721 PECOS PAC ID: 1153786512 Enrollment ID: I20230508002842 |
| Provider Name | Janae Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104460609 PECOS PAC ID: 5799140174 Enrollment ID: I20230509000434 |
| Provider Name | Kettia Duperval |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164733895 PECOS PAC ID: 5991161010 Enrollment ID: I20230516002002 |
| Provider Name | Vanessa Otero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710692603 PECOS PAC ID: 8426414079 Enrollment ID: I20230524000545 |
| Provider Name | Andrew Solow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043942170 PECOS PAC ID: 0244690162 Enrollment ID: I20230724001702 |
| Provider Name | Rosabel Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033804190 PECOS PAC ID: 5890157846 Enrollment ID: I20230808003797 |
| Provider Name | Za Thao |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851712749 PECOS PAC ID: 7911369293 Enrollment ID: I20230817004217 |
| Provider Name | Maria Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285396614 PECOS PAC ID: 5597110924 Enrollment ID: I20231004003929 |
| Provider Name | Melisa Sheldon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205093747 PECOS PAC ID: 5597757534 Enrollment ID: I20231005003796 |
| Provider Name | Joanna Carisma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114601481 PECOS PAC ID: 0840645966 Enrollment ID: I20231010002263 |
| Provider Name | Mamie Lumpkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003177866 PECOS PAC ID: 2860848017 Enrollment ID: I20231025001230 |
| Provider Name | Raneisha Drayton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689208076 PECOS PAC ID: 1456700780 Enrollment ID: I20231212004144 |
| 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 | Orinthea Decarish |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689230393 PECOS PAC ID: 7911359443 Enrollment ID: I20240119001724 |
| 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 | Dawn Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578792362 PECOS PAC ID: 8325490758 Enrollment ID: I20240122000690 |
| Provider Name | Gerald Button |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073630729 PECOS PAC ID: 3577915917 Enrollment ID: I20240122001191 |
| Provider Name | Carolyne Cole |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295367001 PECOS PAC ID: 3678925021 Enrollment ID: I20240122001566 |
| 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 | Shatiria Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508345034 PECOS PAC ID: 3870936149 Enrollment ID: I20240205000653 |
| Provider Name | Janine L Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457590291 PECOS PAC ID: 5597814822 Enrollment ID: I20240206000097 |
| Provider Name | Savanna Deiser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336735281 PECOS PAC ID: 1052754439 Enrollment ID: I20240213002881 |
| Provider Name | Terri Dyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801665591 PECOS PAC ID: 1456795756 Enrollment ID: I20240214002801 |
| 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 | Lanita Parrish |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558666206 PECOS PAC ID: 1456795012 Enrollment ID: I20240222000985 |
| Provider Name | Tricia Antonio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861652422 PECOS PAC ID: 9638306053 Enrollment ID: I20240222001658 |
| Provider Name | Ashley Schmid |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700211471 PECOS PAC ID: 9436595683 Enrollment ID: I20240309000672 |
| Provider Name | Jennyffer Castillo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912769100 PECOS PAC ID: 2860838745 Enrollment ID: I20240313004338 |
| Provider Name | Brianna Mcmaster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730637018 PECOS PAC ID: 1951777564 Enrollment ID: I20240314004264 |
South Broward Hospital District Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1150 N 35th Ave Ste 525, Hollywood, FL 33021 Phone: 954-265-6966 Fax: 954-265-6950 | |
Reclamation Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6966 Taft St, Hollywood, FL 33024 Phone: 954-432-8831 Fax: 954-432-8832 | |
Our Children Our Future, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 N Park Rd, Suite 600, Hollywood, FL 33021 Phone: 954-929-7515 Fax: 954-929-7510 | |
Serenity Behavioral Health Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2303 Hollywood Blvd, Suite 12, Hollywood, FL 33020 Phone: 954-367-7944 Fax: 954-374-8311 | |
My Choice Individual And Family Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2900 Dorchester Ln, Hollywood, FL 33026 Phone: 954-864-4552 | |
Live Free Wellness Institute Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7709 Davie Road Ext, Hollywood, FL 33024 Phone: 305-336-1739 | |
Goddess Health & Wellness, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5420 Hollywood Blvd Apt 111, Hollywood, FL 33021 Phone: 754-300-7591 Fax: 954-206-0496 |