Provider Demographics
NPI:1184211047
Name:NIEVES-YODER, WALESKA MARIEL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WALESKA
Middle Name:MARIEL
Last Name:NIEVES-YODER
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 1:2801 FRUITVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5336
Mailing Address - Country:US
Mailing Address - Phone:941-735-6714
Mailing Address - Fax:
Practice Address - Street 1:2801 FRUITVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5336
Practice Address - Country:US
Practice Address - Phone:941-735-6714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW144391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical