Basic Information
| Provider Information | |||||||||
| NPI: | 1578708509 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANSIN | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | CAROLINA | ||||||||
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| Credential: | MS, LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11501 SW 153RD CT | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331965205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863299993 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14335 SW 120TH ST STE 208 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331867296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863299993 | ||||||||
| FaxNumber: | 3059678302 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2008 | ||||||||
| LastUpdateDate: | 08/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MH9619 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103K00000X | 1-16-23285 | FL | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.