Provider Demographics
NPI:1629700299
Name:BRINONES, KEILAN MARIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KEILAN
Middle Name:MARIA
Last Name:BRINONES
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 1:3777 NW 78TH AVE APT 7F
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8390
Mailing Address - Country:US
Mailing Address - Phone:315-278-0570
Mailing Address - Fax:
Practice Address - Street 1:3777 NW 78TH AVE APT 7F
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8390
Practice Address - Country:US
Practice Address - Phone:315-278-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW196651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical