Provider Demographics
NPI:1598477150
Name:DENIS, VYONKA ALEXIS (LCSW)
Entity Type:Individual
Prefix:
First Name:VYONKA
Middle Name:ALEXIS
Last Name:DENIS
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 1:3409 SE 1ST CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7470
Mailing Address - Country:US
Mailing Address - Phone:786-797-9457
Mailing Address - Fax:
Practice Address - Street 1:3409 SE 1ST CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7470
Practice Address - Country:US
Practice Address - Phone:786-797-9457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW207141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty