Provider Demographics
NPI:1528722683
Name:GOMEZ-BOGOMOLNI, MARCELA (LCSW)
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:GOMEZ-BOGOMOLNI
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 1:12781 MIRAMAR PKWY # 1-203
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2906
Mailing Address - Country:US
Mailing Address - Phone:786-830-5880
Mailing Address - Fax:786-698-7677
Practice Address - Street 1:12781 MIRAMAR PKWY # 1-203
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2906
Practice Address - Country:US
Practice Address - Phone:786-830-5880
Practice Address - Fax:786-698-7677
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW239941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical