OrganizationActive
Sunnyside Love Extravagant Group LLC
NPI 1629603154 · Clinical Social Worker · Miramar, FL
Provider details
- NPI number
- 1629603154
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Tabitha Taylor-Boone, Owner(786) 575-3801
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Counselor101Y00000X
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
- School Counselor101YS0200X
Behavioral Health & Social Service Providers
- Behavior Analyst103K00000X
Behavioral Health & Social Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
Practice location
3600 S State Road 7 Ste 344
Miramar, FL 33023-7203
Phone: (786) 575-3801
Fax: (877) 384-2630
Approximate (ZIP-level) locationGet directions
Mailing address
3600 S State Road 7 Ste 344
Miramar, FL 33023-7203
Additional practice locations (1)
- 1701 W Flagler St Ste 310Miami, FL 33135-2099Phone: (786) 575-3801Fax: (786) 342-9163
Registry dates
- Enumerated
- 2020-03-04
- Last updated
- 2021-08-08
- Certified
- 2021-08-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.