MEDICARE: MS. VALARIE D FIELDS ERVIN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW8212	FL
2	1041C0700X	Clinical Social Worker	SW8212	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760494421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VALARIE D FIELDS ERVIN LCSW

Provider Business Mailing Address
First Line	:	13022 NW 6TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-3107
Country	:	US
Telephone Number	:	954-547-3479
Fax Number	:	954-416-7846

Provider Business Practice Location Address
First Line	:	11820 MIRAMAR PKWY STE 224
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-5818
Country	:	US
Telephone Number	:	954-547-3479
Fax Number	:	954-416-7846

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	02/15/2022

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