Provider Demographics
NPI:1437499837
Name:ESTEVEZ, MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ESTEVEZ
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 1:14281 SW 267TH ST APT 303
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8277
Mailing Address - Country:US
Mailing Address - Phone:786-203-1670
Mailing Address - Fax:
Practice Address - Street 1:14281 SW 267TH ST APT 303
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8277
Practice Address - Country:US
Practice Address - Phone:786-203-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2024-01-30
Deactivation Date:2022-03-05
Deactivation Code:
Reactivation Date:2022-03-26
Provider Licenses
StateLicense IDTaxonomies
FLSW190681041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical