Healthcare Provider Details

I. General information

NPI: 1922722552
Provider Name (Legal Business Name): KY HOELSCHER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 NE 2ND AVE # 1073
MIAMI SHORES FL
33138-2310
US

IV. Provider business mailing address

9701 NE 2ND AVE # 1073
MIAMI SHORES FL
33138-2310
US

V. Phone/Fax

Practice location:
  • Phone: 786-717-1504
  • Fax:
Mailing address:
  • Phone: 986-717-1504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW22990
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number66518
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: