Provider Demographics
NPI:1174191100
Name:LAGAR, MARIA RITA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:RITA
Last Name:LAGAR
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 1:2829 INDIAN CREEK DR APT 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4729
Mailing Address - Country:US
Mailing Address - Phone:305-401-2039
Mailing Address - Fax:
Practice Address - Street 1:2829 INDIAN CREEK DR APT 305
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4729
Practice Address - Country:US
Practice Address - Phone:305-401-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00022331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW0002233OtherFLORIDA LICENSED CLINICAL SOCIAL WORKER