Organization Active NPI

Medi Nurse Behavioral Solutions Inc

  • Professional Counselor
  • Miami, FL
National Provider Identifier
1336199447
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MEDI NURSE BEHAVIORAL SOLUTIONS INC
Practice address
6175 NW 167TH St
Suite G-15
Miami, FL 33015-4339
Phone
(305) 824-8880
Fax
(954) 485-4452
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Charlene M Grecsek, EDD, LMHC
Title
Program Director
Phone
(954) 484-0051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X FL Primary

Addresses

Primary practice location

6175 NW 167TH St
Suite G-15
Miami, FL 33015-4339

Mailing address

2800 W Oakland Park Blvd
Suite 206
Oakland Park, FL 33311-1370
Phone (954) 484-0051

Other identifiers 1

IdentifierTypeStateIssuer
209943OtherFLAMERIGROUP PROVIDER NUM

National Provider Directory

National Provider Directory

Locations

2800 W Oakland Park Blvd
Ste 206
Oakland Park, FL 33311

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1336199447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W OAKLAND PARK BLVD",
            "address_2": "SUITE 206",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111370",
            "telephone_number": "954-484-0051",
            "fax_number": "954-485-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 NW 167TH ST",
            "address_2": "SUITE G-15",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "330154339",
            "telephone_number": "305-824-8880",
            "fax_number": "954-485-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI NURSE BEHAVIORAL SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GRECSEK",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "954-484-0051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER NUM",
            "identifier": "209943",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.