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General NPI Number Information
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NPI Number | 1548883705
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Entity Type | Individual
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Provider Name | SANDRA VALDES LCSW, MCAP
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 7707 NW 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33150-2901
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Country | US
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Telephone | 305-795-0077
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Fax | 305-795-2022
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Provider Business Mailing Address
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Address Line | 8620 NW 23RD ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3357
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Country | US
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Telephone | 305-785-8260
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MCAP100780
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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 | SW16739
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License Number State | FL
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