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General NPI Number Information
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NPI Number | 1760494421
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Entity Type | Individual
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Provider Name | VALARIE D FIELDS ERVIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 11820 MIRAMAR PKWY STE 224
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City | MIRAMAR
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State | FL
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Zip | 33025-5818
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Country | US
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Telephone | 954-547-3479
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Fax | 954-416-7846
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Provider Business Mailing Address
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Address Line | 13022 NW 6TH CT
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-3107
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Country | US
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Telephone | 954-547-3479
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Fax | 954-416-7846
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW8212
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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 | SW8212
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License Number State | FL
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