Provider Demographics
NPI:1417573056
Name:GALCERAN MILLAN, SUSAN CARIDAD (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CARIDAD
Last Name:GALCERAN MILLAN
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 1:12950 SW 117TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4611
Mailing Address - Country:US
Mailing Address - Phone:786-423-9570
Mailing Address - Fax:
Practice Address - Street 1:8200 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-2007
Practice Address - Country:US
Practice Address - Phone:786-423-9570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW151231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical