Provider Demographics
NPI:1538948476
Name:MICHAELI, REN DARIA (LSCW)
Entity type:Individual
Prefix:
First Name:REN
Middle Name:DARIA
Last Name:MICHAELI
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 E 14TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3339
Mailing Address - Country:US
Mailing Address - Phone:305-984-9578
Mailing Address - Fax:
Practice Address - Street 1:851 E 14TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3339
Practice Address - Country:US
Practice Address - Phone:305-984-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW217711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical