Provider Demographics
NPI:1730633884
Name:MENTAL HEALTH CONSULTANTS LLC
Entity type:Organization
Organization Name:MENTAL HEALTH CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA DELCARMEN
Authorized Official - Middle Name:QUINONES
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MH
Authorized Official - Phone:772-634-1400
Mailing Address - Street 1:3991 SW GREENWOOD WAY
Mailing Address - Street 2:SUITE. 3G
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-4639
Mailing Address - Country:US
Mailing Address - Phone:772-634-1400
Mailing Address - Fax:772-600-8975
Practice Address - Street 1:3991 SW GREENWOOD WAY
Practice Address - Street 2:SUITE 3G
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-4639
Practice Address - Country:US
Practice Address - Phone:772-634-1400
Practice Address - Fax:772-600-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000672700Medicaid