Provider Demographics
NPI:1871967398
Name:AVILES CERVERA, SANDRA TATIANA (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:TATIANA
Last Name:AVILES CERVERA
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9840 ROWING DALE BND
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4947
Mailing Address - Country:US
Mailing Address - Phone:301-820-2352
Mailing Address - Fax:
Practice Address - Street 1:9840 ROWING DALE BND
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4947
Practice Address - Country:US
Practice Address - Phone:301-820-2352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD153861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical