Provider Demographics
NPI:1346550084
Name:VISBAL, MARIA EUGENIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:EUGENIA
Last Name:VISBAL
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 1:25 FLATBUSH AVENUE
Mailing Address - Street 2:SOUTH BEACH PSYCHIATRIC CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217
Mailing Address - Country:US
Mailing Address - Phone:718-875-1420
Mailing Address - Fax:718-875-5496
Practice Address - Street 1:25 FLATBUSH AVENUE
Practice Address - Street 2:SOUTH BEACH PSYCHIATRIC CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217
Practice Address - Country:US
Practice Address - Phone:718-875-1420
Practice Address - Fax:718-875-5496
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0423981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical