Clinicians of South Dade LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CLINICIANS OF SOUTH DADE LLC

Practice address

333 SE 2ND Ave Ste 2000
Miami, FL 33131-2185

Phone

(919) 672-5005

NPI assigned

May 22, 2020

Last updated

May 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dashun Tyrell BanksNPI 1972821916

Title

Ceo

Phone

(919) 672-5005

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dashun Tyrell Banks, NCLPCBE

  • Counselor
  • Concord, NC
  • NPI 1972821916
  Authorized official Same address or phone
• Javious Ellis, MSW

  • Clinical Social Worker
  • Shelby, NC
  • NPI 1821611518
  NPD
• Francisca Ngozi Odoemena, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1942814298
  NPD

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1982227070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N TRYON ST STE 1609",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282020202",
            "telephone_number": "919-672-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SE 2ND AVE STE 2000",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312185",
            "telephone_number": "919-672-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICIANS OF SOUTH DADE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "DASHUN",
        "authorized_official_middle_name": "TYRELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-672-5005"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinomed, Inc.
• CLJ Care LLC (PCAH Miami Beach)
• Matthew Clock, LPN
• Valeria J Clock

• Mental Health Counselor in Miami, FL
• Providers in Miami, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.