Organization Active NPI

Millenium Clinic of Dade, Inc

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1861843047
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MILLENIUM CLINIC OF DADE, INC
Practice address
500 NW 165TH St
Ste 206
Miami, FL 33169-6306
Phone
(786) 657-2272
NPI assigned
Jun 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Authorized official

Name
Kimberly Lynn Roberts, EDM
Title
Group Facilitator
Phone
(718) 785-6367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

500 NW 165TH St
Ste 206
Miami, FL 33169-6306

Mailing address

500 NW 165TH St
Ste 206
Miami, FL 33169-6306
Phone (786) 657-2272

National Provider Directory

National Provider Directory

Locations

500 NW 165th St
Ste 206
Miami, FL 33169
Phone (786) 657-2272

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1861843047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NW 165TH ST",
            "address_2": "STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331696306",
            "telephone_number": "786-657-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NW 165TH ST",
            "address_2": "STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331696306",
            "telephone_number": "786-657-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENIUM CLINIC OF DADE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "GROUP FACILITATOR",
        "authorized_official_telephone_number": "718-785-6367",
        "authorized_official_credential": "EDM"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 28, 2016; 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.