Authentic Behavioral Health, Llc | |
9050 Pines Blvd Ste 450-00 Pembroke Pines FL 33024-6455 | |
(954) 715-5477 | |
Not Available |
Full Name | Authentic Behavioral Health, Llc |
---|---|
Speciality | Psychologist |
Location | 9050 Pines Blvd Ste 450-00, Pembroke Pines, Florida |
Authorized Official Name and Position | Lydia Rosa Malcolm (OWNER) |
Authorized Official Contact | 9547155477 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Authentic Behavioral Health, Llc 18459 Pines Blvd Ste 120 Pembroke Pines FL 33029-1400 Ph: (954) 715-5477 | Authentic Behavioral Health, Llc 9050 Pines Blvd Ste 450-00 Pembroke Pines FL 33024-6455 Ph: (954) 715-5477 |
NPI Number | 1487157715 |
---|---|
Provider Enumeration Date | 03/13/2018 |
Last Update Date | 01/12/2022 |
Certification Date | 01/12/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487157715 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PY10094 (Florida) | Primary |
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