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General NPI Number Information
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NPI Number | 1346457629
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Entity Type | Individual
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Provider Name | SITHEMBILE MAHLATINI ED.D, LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1331 S INTERNATIONAL PKWY
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City | LAKE MARY
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State | FL
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Zip | 32746-1405
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Country | US
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Telephone | 781-254-1602
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Fax | 888-306-7208
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Provider Business Mailing Address
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Address Line | 100 SAPPHIRE PT UNIT 120
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City | LAKE MARY
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State | FL
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Zip | 32746-5434
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Country | US
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Telephone | 781-254-1602
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Fax | 888-306-7208
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW7156
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 114616
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License Number State | MA
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