Provider Demographics
NPI:1629185624
Name:MUKATI, MERCEDES MILOCCOS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MERCEDES
Middle Name:MILOCCOS
Last Name:MUKATI
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 1:1201 NW 16TH ST
Mailing Address - Street 2:ROUTING #122
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-324-4455
Mailing Address - Fax:305-575-3380
Practice Address - Street 1:1201 NW 16TH ST
Practice Address - Street 2:ROUTING #122
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-324-4455
Practice Address - Fax:305-575-3380
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW4753104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker