Healthcare Provider Details

I. General information

NPI: 1982253076
Provider Name (Legal Business Name): MONIKA LA NUEZ, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6919 SW 18TH STREET SUITE 200-239
BOCA RATON FL
33433
US

IV. Provider business mailing address

8098 RAINFOREST JASPER LN
DELRAY BEACH FL
33446-2254
US

V. Phone/Fax

Practice location:
  • Phone: 917-843-7803
  • Fax:
Mailing address:
  • Phone: 917-843-7803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. MONIKA LA NUEZ
Title or Position: MANAGER
Credential: LCSW
Phone: 917-843-7803