Crystal Mind Behavioral Inc

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

CRYSTAL MIND BEHAVIORAL INC

Practice address

11890 SW 8TH St Ste 401
Miami, FL 33184-1710

Phone

(786) 707-8599

NPI assigned

Aug 2, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gretel Loyola Herrera

Title

Authorized Official

Phone

(786) 707-8599

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1073343380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11890 SW 8TH ST STE 401",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841710",
            "telephone_number": "786-707-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11890 SW 8TH ST STE 401",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841710",
            "telephone_number": "786-707-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL MIND BEHAVIORAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "LOYOLA HERRERA",
        "authorized_official_first_name": "GRETEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-707-8599"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Miami, FL
• Providers in Miami, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.