Healthcare Provider Details

I. General information

NPI: 1851880587
Provider Name (Legal Business Name): STEPHANIE YCASA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 N 69TH WAY
HOLLYWOOD FL
33024-3704
US

IV. Provider business mailing address

2330 N 69TH WAY
HOLLYWOOD FL
33024-3704
US

V. Phone/Fax

Practice location:
  • Phone: 786-975-8265
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: