Healthcare Provider Details

I. General information

NPI: 1659280378
Provider Name (Legal Business Name): MONIQUE DENISE GELETY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MONIQUE DENISE LUSAN LCSW

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 SW 74TH TER APT 5
SOUTH MIAMI FL
33143-5265
US

IV. Provider business mailing address

5801 SW 74TH TER APT 5
SOUTH MIAMI FL
33143-5265
US

V. Phone/Fax

Practice location:
  • Phone: 305-713-3003
  • Fax:
Mailing address:
  • Phone: 305-713-3003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: