Provider Demographics
NPI:1619789575
Name:NORTHSTAR COUNSELING AND THERAPY LLC
Entity type:Organization
Organization Name:NORTHSTAR COUNSELING AND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:
Authorized Official - First Name:MILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITROVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-303-9347
Mailing Address - Street 1:1313 NW 125TH TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3182
Mailing Address - Country:US
Mailing Address - Phone:786-303-9347
Mailing Address - Fax:
Practice Address - Street 1:1313 NW 125TH TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3182
Practice Address - Country:US
Practice Address - Phone:786-303-9347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty