Provider Demographics
NPI:1639285646
Name:URBANO, LEDIA (LCSW, CAC)
Entity Type:Individual
Prefix:
First Name:LEDIA
Middle Name:
Last Name:URBANO
Suffix:
Gender:F
Credentials:LCSW, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5706 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-1450
Mailing Address - Country:US
Mailing Address - Phone:954-961-9536
Mailing Address - Fax:
Practice Address - Street 1:6848 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-1842
Practice Address - Country:US
Practice Address - Phone:954-362-0104
Practice Address - Fax:954-364-4595
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1038A101YA0400X
FLSW 57621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)