Provider Demographics
NPI:1174196844
Name:SENATUS, NADLY (LCSW)
Entity Type:Individual
Prefix:
First Name:NADLY
Middle Name:
Last Name:SENATUS
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 1:19821 NW 2ND AVE # 217
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-3341
Mailing Address - Country:US
Mailing Address - Phone:305-767-3886
Mailing Address - Fax:
Practice Address - Street 1:20623 NW 11TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2344
Practice Address - Country:US
Practice Address - Phone:305-767-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW146041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCBHCM102266OtherFLORIDA CERTIFICATION BOARD
FLSW14604OtherFLORIDA DEPARTMENT OF HEALTH