Provider Demographics
NPI:1245775741
Name:WARNER, NATALYA (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:WARNER
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 1:2924 ROYAL TUSCAN LN
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-2600
Mailing Address - Country:US
Mailing Address - Phone:407-929-5127
Mailing Address - Fax:
Practice Address - Street 1:401 N PARSONS AVE
Practice Address - Street 2:SUITE 107A
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4538
Practice Address - Country:US
Practice Address - Phone:813-967-1376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL109791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty