SUNNYSIDE LOVE EXTRAVAGANT GROUP LLC NPI 1629603154

NPI Information

NPI: 1629603154
Provider Name: SUNNYSIDE LOVE EXTRAVAGANT GROUP LLC
Classification: Social Worker - 1041C0700X
Specialization: Clinical
Entity Type: Organization
Address: 3600 S STATE ROAD 7 STE 344
MIRAMAR, FL
ZIP 33023
Phone: (786) 575-3801

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NPI Details

SUNNYSIDE LOVE EXTRAVAGANT GROUP LLC is a clinical social worker in Miramar, FL. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SUNNYSIDE LOVE EXTRAVAGANT GROUP LLC NPI is 1629603154. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3600 S STATE ROAD 7 STE 344
MIRAMAR, FL
ZIP 33023-203
Phone: (786) 575-3801
Fax: (877) 384-2630

The provider's authorized official is Tabitha S Taylor-boone .
The authorized official title is Owner and has the following contact phone number (786) 575-3801.

The enumeration date for this NPI number is 3/4/2020 and was last updated on 8/8/2021.

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	Primary
1	104100000X	Social Worker		No
2	1041S0200X	Social Worker	School	No
3	174H00000X	Health Educator		No
4	251B00000X	Case Management		No
5	251G00000X	Hospice Care, Community Based		No
6	251S00000X	Community/Behavioral Health		No
7	253Z00000X	In Home Supportive Care		No
8	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
9	261QM0850X	Clinic/Center	Adult Mental Health	No
10	101Y00000X	Counselor		No
11	101YM0800X	Counselor	Mental Health	No
12	101YP2500X	Counselor	Professional	No
13	101YS0200X	Counselor	School	No
14	103K00000X	Behavior Analyst		No
15	1041C0700X	Social Worker	Clinical	Yes

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	022925900	MEDICAID	FLORIDA
2	1750945689	OTHER	FLORIDA	NPI

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: 3/30/2025

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