Healthcare Provider Details

I. General information

NPI: 1992914386
Provider Name (Legal Business Name): YASMIN I LLUVERAS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SOLAREX CT
FREDERICK MD
21703-7005
US

IV. Provider business mailing address

700 S STONESTREET AVE
ROCKVILLE MD
20850-4113
US

V. Phone/Fax

Practice location:
  • Phone: 240-643-2728
  • Fax:
Mailing address:
  • Phone: 240-643-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11503
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: