Provider Demographics
NPI:1174965743
Name:NERYS-CHAHIN, MIGUEL A (MS, NCC)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:NERYS-CHAHIN
Suffix:
Gender:M
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 SE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5211
Mailing Address - Country:US
Mailing Address - Phone:561-755-7179
Mailing Address - Fax:954-497-3857
Practice Address - Street 1:440 SE 5TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5211
Practice Address - Country:US
Practice Address - Phone:561-755-7179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH9550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health