Healthcare Provider Details

I. General information

NPI: 1114860376
Provider Name (Legal Business Name): BIANCA CORCHADO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BIANCA MONDESTIN

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18519 ANCHOR DR
BOCA RATON FL
33498-6301
US

IV. Provider business mailing address

18519 ANCHOR DR
BOCA RATON FL
33498-6301
US

V. Phone/Fax

Practice location:
  • Phone: 561-213-8540
  • Fax:
Mailing address:
  • Phone: 561-213-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: