# TEEN ADDICTION TREATMENT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689126161
- **Authorized official:** MR. ROBERT NIZNIK (CEO)
- **Authorized official phone:** (786) 923-3310

## Contact information

- **Practice address:** 1515 NW 167TH ST, \#430, MIAMI, FL 33169-5100
- **Practice address phone:** (786) 923-3310
- **Mailing address:** 1515 NW 167TH ST, \#430, MIAMI, FL 33169-5100
- **Mailing address phone:** (786) 923-3310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | Yes |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 103TF0000X | Family Psychologist | — | NULL | — |
| 103TF0000X | Family Psychologist | — | — | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |

## Other

- **Enumeration date:** 10/31/2016
- **Last updated:** 10/31/2016