Healthcare Provider Details

I. General information

NPI: 1700973252
Provider Name (Legal Business Name): LORA NAMOFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S ROYAL POINCIANA BLVD STE 300
MIAMI SPRINGS FL
33166-6667
US

IV. Provider business mailing address

700 S ROYAL POINCIANA BLVD STE 300
MIAMI SPRINGS FL
33166-6667
US

V. Phone/Fax

Practice location:
  • Phone: 305-668-9000
  • Fax: 305-662-1788
Mailing address:
  • Phone: 305-668-9000
  • Fax: 305-662-1788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberSW7828
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberSW7828
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW7828
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: