Provider Demographics
NPI:1548327828
Name:BARON, DARLISE (PHD, LCSW, CAP,CST)
Entity type:Individual
Prefix:DR
First Name:DARLISE
Middle Name:
Last Name:BARON
Suffix:
Gender:F
Credentials:PHD, LCSW, CAP,CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18441 NW 2ND AVE
Mailing Address - Street 2:116
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4517
Mailing Address - Country:US
Mailing Address - Phone:786-853-7192
Mailing Address - Fax:
Practice Address - Street 1:18441 NW 2ND AVE STE 116
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4571
Practice Address - Country:US
Practice Address - Phone:786-320-8722
Practice Address - Fax:786-320-6891
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 251B00000X
FLSW76291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003344200Medicaid
FL016758700Medicaid