Provider Demographics
NPI:1730940503
Name:MENDEZ MARIN, MARIA DEL CARMEN (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:MENDEZ MARIN
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 1:919 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2012
Mailing Address - Country:US
Mailing Address - Phone:786-930-8806
Mailing Address - Fax:
Practice Address - Street 1:919 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-2009
Practice Address - Country:US
Practice Address - Phone:954-763-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW222591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical