Provider Demographics
NPI:1447411558
Name:VILLAVERDE, ANA MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:VILLAVERDE
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 1:1250 S MIAMI AVE APT 2402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4117
Mailing Address - Country:US
Mailing Address - Phone:305-283-2714
Mailing Address - Fax:
Practice Address - Street 1:33 SW 2ND AVE STE 901
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1584
Practice Address - Country:US
Practice Address - Phone:786-275-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW9038104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAZ0202ZMedicare PIN