Provider Demographics
NPI:1104220060
Name:SHKOLNIK, NIURKA CANELO (LCSW)
Entity Type:Individual
Prefix:
First Name:NIURKA
Middle Name:CANELO
Last Name:SHKOLNIK
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 1:9497 OLD PINE RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-3055
Mailing Address - Country:US
Mailing Address - Phone:305-297-9512
Mailing Address - Fax:
Practice Address - Street 1:7000 W PALMETTO PARK RD STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3430
Practice Address - Country:US
Practice Address - Phone:561-444-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189121041C0700X
FLSW132661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical