Provider Demographics
NPI:1578144499
Name:ALBERTIE, WAYNE (MSW)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:
Last Name:ALBERTIE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6523
Mailing Address - Country:US
Mailing Address - Phone:786-299-3221
Mailing Address - Fax:786-300-3579
Practice Address - Street 1:13227 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-2803
Practice Address - Country:US
Practice Address - Phone:786-703-9866
Practice Address - Fax:786-300-3579
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW109611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical