Provider Demographics
NPI:1902346695
Name:GONZALEZ, MILADYS (LCSW)
Entity Type:Individual
Prefix:
First Name:MILADYS
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 TAMIAMI TRL N STE 202
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4457
Mailing Address - Country:US
Mailing Address - Phone:239-530-3132
Mailing Address - Fax:
Practice Address - Street 1:2335 TAMIAMI TRL N STE 202
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4457
Practice Address - Country:US
Practice Address - Phone:239-530-3132
Practice Address - Fax:239-353-6807
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW143451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical