Provider Demographics
NPI:1144927146
Name:PAULINO, ERICK (LCSW)
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:PAULINO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 NW 21ST ST APT 1112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-7745
Mailing Address - Country:US
Mailing Address - Phone:786-899-1490
Mailing Address - Fax:
Practice Address - Street 1:1250 NW 21ST ST APT 1112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-7745
Practice Address - Country:US
Practice Address - Phone:786-899-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW189751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty