Provider Demographics
NPI:1174302749
Name:STRONG MIND MENTAL HEALTH LLC
Entity type:Organization
Organization Name:STRONG MIND MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:305-766-5153
Mailing Address - Street 1:5882 NE 17TH RD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5935
Mailing Address - Country:US
Mailing Address - Phone:305-766-5153
Mailing Address - Fax:
Practice Address - Street 1:5882 NE 17TH RD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-5935
Practice Address - Country:US
Practice Address - Phone:305-766-5153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty