Provider Demographics
NPI:1033510599
Name:AFRICANO, GLADIS (MSW, RCSW)
Entity Type:Individual
Prefix:
First Name:GLADIS
Middle Name:
Last Name:AFRICANO
Suffix:
Gender:F
Credentials:MSW, RCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 NW 12TH TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1220
Mailing Address - Country:US
Mailing Address - Phone:305-320-9242
Mailing Address - Fax:
Practice Address - Street 1:1501 NW 12TH TER
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1220
Practice Address - Country:US
Practice Address - Phone:305-320-9242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW5257101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health