Healthcare Provider Details

I. General information

NPI: 1003258914
Provider Name (Legal Business Name): NORALIZ NAGARSHETH MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 STIRLING CENTER PL STE 1709
LAKE MARY FL
32746-5712
US

IV. Provider business mailing address

743 STIRLING CENTER PL STE 1709
LAKE MARY FL
32746-5712
US

V. Phone/Fax

Practice location:
  • Phone: 689-216-4480
  • Fax: 407-522-4671
Mailing address:
  • Phone: 689-216-4480
  • Fax: 407-522-4671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17647
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: