Organization
MENTAL WELLNESS CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BERRY LMHC (CEO)
(305) 338-4027
Entity
Organization
Contact information
Practice address
3580 MYSTIC POINTE DR, AVENTURA, FL 33180-2554
(786) 708-7166
Mailing address
309 S 57TH TER, HOLLYWOOD, FL 33023-1426
(305) 338-4027
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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