SAMIR GUSTAVO JEREZ LMHC QS NPI 1912916289

NPI Information

NPI: 1912916289
Provider Name: SAMIR GUSTAVO JEREZ, LMHC, QS
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
11855 SW 216TH ST
MIAMI, FL
ZIP 33170
Phone: (786) 601-2608
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Samir Gustavo Jerez, LMHC, QS is a mental health counselor in Miami, FL. Samir Gustavo Jerez, LMHC, QS NPI is 1912916289. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11855 SW 216TH ST
MIAMI, FL
ZIP 33170-945
Phone: (786) 601-2608
Fax: (305) 647-0250

The enumeration date for this NPI number is 8/5/2006 and was last updated on 6/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	MH5950	FLORIDA	Yes
2	103K00000X	Behavior Analyst		MH5950	FLORIDA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	007140600	MEDICAID	FLORIDA
2	018278700	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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