Provider Demographics
NPI:1023536588
Name:CUNEO, ERICA RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:RAE
Last Name:CUNEO
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 1:12421 SW 28TH PL
Mailing Address - Street 2:
Mailing Address - City:ARCHER
Mailing Address - State:FL
Mailing Address - Zip Code:32618-2135
Mailing Address - Country:US
Mailing Address - Phone:352-505-3507
Mailing Address - Fax:
Practice Address - Street 1:12421 SW 28TH PL
Practice Address - Street 2:
Practice Address - City:ARCHER
Practice Address - State:FL
Practice Address - Zip Code:32618-2135
Practice Address - Country:US
Practice Address - Phone:352-505-3507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW122851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW12285OtherLICENSED CLINICAL SOCIAL WORKER