Provider Demographics
NPI:1083048367
Name:TIRADO, SONIA (LMSW)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:TIRADO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 RANDALL AVE
Mailing Address - Street 2:APT. 4F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1736
Mailing Address - Country:US
Mailing Address - Phone:917-599-7601
Mailing Address - Fax:
Practice Address - Street 1:579 COURTLANDT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5013
Practice Address - Country:US
Practice Address - Phone:718-485-2100
Practice Address - Fax:718-485-2101
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0051534104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker